Changes in breast cancer management and care infrastructure in Turkiye: a ten-year multicenter comparison, 2009–2019

To evaluate changes in breast cancer management infrastructure, diagnostic approaches, and treatment practices in tertiary breast centers in Turkiye between 2009 and 2019 and identify areas requiring further development. This repeated cross-sectional multicenter institutional survey compared aggregated center-level data from 2009 to 2019. Data included pathologically confirmed breast cancer cases, diagnostic sampling, stage at diagnosis, breast and axillary surgery, neoadjuvant therapy, imaging availability, and specialized multidisciplinary and supportive-care services. Individual recurrence and survival outcomes were unavailable. Thirty-eight centers contributed data in 2009 and 44 in 2019, with confirmed cases increasing from 4,808 to 6,550 (p < 0.001). The number of specialized breast surgeons increased. Core needle biopsy largely replaced excisional/incisional diagnostic procedures (p < 0.001), while neoadjuvant therapy use increased (p < 0.001). Surgical management shifted toward breast-conserving surgery. The reported proportion of sentinel lymph node biopsy (SLNB) increased from approximately 48% to 55%; however, the aggregated dataset did not include clinical nodal status or patient-level indications for SLNB, so appropriateness of axillary staging cannot be assessed. Availability of diagnostic imaging, medical oncology/chemotherapy units, and lymphedema services also improved, although progress remained uneven across multidisciplinary and supportive-care domains. Participating Turkish tertiary breast centers demonstrated substantial structural and procedural changes between 2009 and 2019 that were broadly consistent with evolving breast cancer care. Because patient-level treatment indications and longitudinal outcomes were unavailable, the appropriateness of individual axillary procedures and effects on disease-free or overall survival cannot be determined.