Introduction

Doctors who are diagnosed with breast cancer make up a small but unique subset of women owing to their medical knowledge. Anecdote suggests that doctors with breast cancer are more likely to opt for mastectomy than non-medically qualified patients.

The primary aim of this study was to compare mastectomy rates in medically-qualified doctors with degree-educated controls with breast cancer.

Methods

Research ethics approval was obtained. Patients diagnosed with breast cancer between 1/1/2006 and 31/12/2011 and who had signed a generic research consent form were included in this observational study. Every patient was screened by occupation independently by 2 investigators to identify medically-qualified doctors and suitable (degree-educated) controls such as teachers, lawyers etc. Those with a medical background (e.g.nurse, physiotherapist etc) but not a medical doctor were excluded. Further exclusions were necessary if patients who were reviewed for a second opinion, reconstruction only or radiotherapy only or were male, surgery was not performed, BRCA positivity (might opt for bilateral mastectomy), unusual histology (e.g. lymphoma, sarcoma), recurrence or had a past history of contralateral breast cancer. Doctors and controls were compared by age, tumour characteristics and treatments using Student's t test for continuous variables and Fisher's exact test for categorical variables.

Results:

In total 8623 patients were reviewed and/or treated for breast cancer of whom 5215 had signed the generic research consent form. Overall 607 were either doctors or appropriate occupation controls. After exclusions 473 patients were eligible to be included in the analysis. Of these: 51 were medically-qualified doctors and 422 were degree-educated (controls).

Comparison of tumour characteristics and treatment between doctors and controls

  Doctors Controls 
Number 51 422   
Mean age (years) 53.3 50.8 0.11 
Mean total tumour size (mm) 32.2 31.6 0.89 
        
  Number (%) Number (%) 
DCIS alone 10(20) 53 (13) 0.18 
Node positive 16 (31) 157 (37) 0.44 
ER positive 45 (88) 337 (80) 0.18 
HER2 positive 12 (24) 113 (27) 0.73 
        
Neoadjuvant chemotherapy 6 (12) 58 (14) 0.83 
Adjuvant chemotherapy 14 (27) 154 (36) 0.21 
        
mastectomy 17 (33) 145 (34) 1.00 
Immediate reconstruction 9 (53) 65 (45) 0.61 
Post mastectomy radiotherapy 5 (29) 68 (47) 0.20 
  Doctors Controls 
Number 51 422   
Mean age (years) 53.3 50.8 0.11 
Mean total tumour size (mm) 32.2 31.6 0.89 
        
  Number (%) Number (%) 
DCIS alone 10(20) 53 (13) 0.18 
Node positive 16 (31) 157 (37) 0.44 
ER positive 45 (88) 337 (80) 0.18 
HER2 positive 12 (24) 113 (27) 0.73 
        
Neoadjuvant chemotherapy 6 (12) 58 (14) 0.83 
Adjuvant chemotherapy 14 (27) 154 (36) 0.21 
        
mastectomy 17 (33) 145 (34) 1.00 
Immediate reconstruction 9 (53) 65 (45) 0.61 
Post mastectomy radiotherapy 5 (29) 68 (47) 0.20 

Comparison of age, tumour characteristics, mastectomy, chemotherapy and post mastectomy radiotherapy rates between doctors and the control group

There was no statistical difference in age and tumour characteristics between the doctors with breast cancer and the control group. There was no statistical difference in chemotherapy rate, mastectomy rate, or uptake of immediate breast reconstruction or post-mastectomy radiotherapy in mastectomy patients between the doctors with breast cancer and the control group.

Conclusion

Doctors in this study were not statistically more likely to undergo mastectomy than controls.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-09-18.