Taylor LJ, et al. - In view of previous studies reporting an increase in the use of mastectomy for management of lobular carcinoma in situ (LCIS), but not distinguishing between uni- and bilateral mastectomies, researchers investigated national practice patterns and issues linked to unilateral mastectomy. Study results revealed that unilateral mastectomy (4%) was performed on nearly as many patients as bilateral mastectomy (5.1%), which represents inappropriate care. They suggest improving provider and patient education regarding optimal management of LCIS to reduce unnecessary care.

Methods

• Women with a diagnosis of LCIS between 2004 to 2013 were identified using the National Cancer Database.
• Surgical treatment was described using descriptive statistics.
• Researchers used multinomial logistic regression to determine temporal, patient, and facility-level factors linked to receipt of uni- and bilateral mastectomy.

Results

• Researchers identified 30,105 women with LCIS; 5.4%, of these had no surgery, 84.8% underwent surgical excision, 4% had unilateral mastectomy, and 5.1% underwent bilateral mastectomy.
• Both uni- and bilateral mastectomy were noted in association with young age, white race, insurance coverage, greater comorbidity, and geographic region (p < 0.001) in adjusted analysis.
• Additionally, bilateral mastectomy was observed in association with more recent year of diagnosis.
• Within geographic regions, unilateral mastectomy rates ranged from 2.7% in New England to 8% in the South.