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Prophylactic surgery

Z21_PROPHYLACT_SURGE

Endpoint definition

Endpoint definition steps

FinnGen

Phenotype data

520210

1. Apply sex-specific rule

None

520210

2. Check conditions

None

520210

3. Check pre-conditions, main-only, mode, registry filters

Registry filters:

  • Hospital discharge: ICD-10 Z40
  • Cause of death: ICD-10 Z40

2 out of 7 registries used, show all original rules.

269

4. Check minimum number of events

None

269

5. Include endpoints

None

269

6. Filter based on genotype QC (FinnGen only)

269

Control definitions (FinnGen only)

Control exclude
Z21_PERSONS_ENCOUNTERI_HEALTH_SERVI_SPECIFIC_PROCED_HEALTH_CARE

Extra metadata

Level in the ICD hierarchy
3
First used in FinnGen datafreeze
DF4
Parent code in ICD-10
Z4|Z5[0-4]

Case counts by codes

FinnGen case counts by registry codes:

generic upset plot

Upset plot

Full data table

Summary Statistics

-FinRegistry-

This endpoint is excluded from FinRegistry analyses (omitted endpoint).

-FinnGen-

Key figures

All Female Male
Number of individuals 269 251 18
Unadjusted period prevalence (%) 0.08 0.09 0.01
Median age at first event (years) 46.01 45.72 50.00

-FinnGen-

Age distribution of first events

-FinnGen-

Year distribution of first events

-FinnGen-

Cumulative Incidence Function

Not a core endpoint, no data to show.

CodeWAS (R11)

CodeWAS is a tool for exploring the associations between an endpoint and all of the medical codes and drug codes.

This is a new tool, please reach out using the contact form for feedback and improvement ideas.

First, a cohort is built by matching controls to the endpoint cases using year of birth and sex. Then, a Fisher test is done for all the medical codes and drug codes between the cases and controls of this cohort. Codes are reported in the table below if they have −log10(p-value) ≥ 6.

Matched cohort

Matched cases
232
Matched controls
2318
Code
Vocabulary
Description
Odds Ratio
-log10(p)
N matched cases
N matched controls
Z40.0
ICD-10 Finland
Prophylactic surgery for risk-factors related to malignant neoplasms
+∞
247.4
191
*
Z80.3
ICD-10 Finland
Family history of malignant neoplasm of breast
294.6
146.2
136
11
Z31.5
ICD-10 Finland
Genetic counselling
37.4
94.3
125
70
LAF11
NOMESCO Finland
Laparoscopic bilateral salpingo-oophorectomy
35.3
78.6
104
52
HAE10
NOMESCO Finland
Reconstruction of breast using graft or flap
93.9
67.0
72
11
HA1AE
NOMESCO Finland
Ultrasound examination of mammary glands
20.3
67.0
108
95
HA1AA
NOMESCO Finland
X-ray mammography
19.8
64.2
104
91
HAC15
NOMESCO Finland
Subcutaneous mastectomy with excision of mamilla
130.6
63.8
66
7
Z42.1
ICD-10 Finland
Follow-up care involving plastic surgery of breast
+∞
63.5
58
*
HAE99
NOMESCO Finland
Other reconstruction of breast
267.8
61.3
60
*
HA1CG
NOMESCO Finland
Extensive MRI examination of mammary gland with high intensity magnet
55.0
59.7
70
18
115
Kela drug reimbursment
Breast cancer
15.4
54.5
98
105
R4110
NOMESCO Finland
Physiotherapy
9.7
53.6
144
334
HAC20
NOMESCO Finland
Total mastectomy
32.9
49.3
65
27
WX404
NOMESCO Finland
Intravenous generell anesthesy
8.4
46.5
132
313
C50.41
ICD-10 Finland
Malignant tumor of the upper outer quadrant of the mammary gland, ductal tumor
19.2
46.2
73
54
TQW20
NOMESCO Finland
Tatoe
53.5
45.9
54
13
H02AB02
ATC
dexamethasone; systemic
13.4
44.3
83
92
HAE20
NOMESCO Finland
Reconstruction of areola and mamilla using graft or flap
57.5
43.1
50
11
HAE00
NOMESCO Finland
Reconstruction of breast using prosthesis
254.7
42.4
42
*
HAC10
NOMESCO Finland
Subcutaneous mastectomy with preservation of mamilla
418.7
37.1
36
*
L02BA01
ATC
tamoxifen; oral
18.5
36.1
57
40
TQB05
NOMESCO Finland
Puncture of skin of trunk
92.8
36.1
39
5
QBB10
NOMESCO Finland
Major dressing of wound of skin of trunk
20.9
35.9
54
33
PJA12
NOMESCO Finland
Sentinel node biopsy
10.2
35.4
76
105
ZXD10
NOMESCO Finland
Scheduled procedure
5.9
35.0
153
572
WX402
NOMESCO Finland
General anaesthesia
6.9
33.7
101
233
HAD60
NOMESCO Finland
Replacement of prosthetic implant in breast
136.6
33.7
35
*
WX408
NOMESCO Finland
General anesthesy, balanced
6.0
32.4
115
327
A03FA01
ATC
metoclopramide; systemic, rectal
6.3
32.2
105
268
THW99
NOMESCO Finland
Other minor procedure in surgery of mammary gland
31.7
31.9
42
16
QBE30
NOMESCO Finland
Excision and repair of surgical scar in trunk
79.1
30.8
34
5
WB113
NOMESCO Finland
Multiple adjuvant cytostatic therapy
12.7
30.7
57
58
ZXE10
NOMESCO Finland
More than one and less than three hours
5.2
30.5
142
537
HA1CM
NOMESCO Finland
Mammary gland extensive MRI examination with 3 Tesla magnet
123.0
30.5
32
*
ZXA00
NOMESCO Finland
Right side
5.8
30.3
109
309
QB2S1
NOMESCO Finland
Photography of skin or subcutaneous tissue in chest
76.4
29.8
33
5
B01AB05
ATC
enoxaparin; parenteral
5.3
29.3
120
391
C50.90
ICD-10 Finland
Malignant tumor in other or unspecified location in mammary gland without histology
56.5
29.3
34
7
PJD52
NOMESCO Finland
Block dissection of axillary lymph nodes
17.9
27.3
43
29
Z2221
NOMESCO Finland
Medical doctor
4.8
26.9
127
469
ZZF00
NOMESCO Finland
Graft of adipose tissue
46.0
26.6
32
8
Z40.8
ICD-10 Finland
Other prophylactic surgery
+∞
26.6
25
*
ZXA05
NOMESCO Finland
Left side
5.3
26.4
98
279
ZXE40
NOMESCO Finland
More than seven and less than nine hours
40.9
26.0
32
9
8500/3-C50.9
ICD-O-3
Infiltrating duct carcinoma, NOS, of breast, NOS
13.6
25.0
44
39
ZXE30
NOMESCO Finland
More than five and less than seven hours
16.4
24.7
40
29
ZZR10
NOMESCO Finland
Flap of skin and muscle
63.3
24.6
28
5
Z3231
NOMESCO Finland
Registered nurse
4.9
24.6
101
316
Z85.3
ICD-10 Finland
Personal history of malignant neoplasm of breast
47.0
24.2
29
7
Z80.4
ICD-10 Finland
Family history of malignant neoplasm of genital organs
72.7
23.3
26
*
C50.99
ICD-10 Finland
Breast, unspecified
20.7
23.0
34
19
HAE05
NOMESCO Finland
Reconstruction of breast using soft tissue and prosthesis
69.6
22.3
25
*
A04AA02
ATC
granisetron; systemic, transdermal
10.8
22.3
44
49
Z3226
NOMESCO Finland
Physiotherapist
5.4
22.3
77
196
ZXE20
NOMESCO Finland
More than three and less than five hours
6.6
21.8
61
119
C50.40
ICD-10 Finland
Malignant tumor of the upper outer quadrant of the mammary gland, no histological veryfication
22.1
21.5
31
16
HAD20
NOMESCO Finland
Liposuction of breast
217.6
19.9
20
*
HA1AT
NOMESCO Finland
Biopsy of mammary glands with ultrasound guidance
14.0
19.8
34
28
Z80.0
ICD-10 Finland
Family history of malignant neoplasm of digestive organs
29.0
19.6
26
10
T81.4
ICD-10 Finland
Infection following a procedure, not elsewhere classified
6.2
19.0
55
111
ZXA10
NOMESCO Finland
Bilateral
4.6
18.2
73
212
A04AA01
ATC
ondansetron; systemic, rectal
9.4
18.1
38
47
LC2AE
NOMESCO Finland
Ultrasound examination of uterus and parametria
4.4
17.9
76
233
ZXE00
NOMESCO Finland
One hour or less
3.4
17.5
134
663
LC2BE
NOMESCO Finland
Transvaginal ultrasound examination of uterus, parametria and lower abdomen
3.4
17.2
135
680
ZXE04
NOMESCO Finland
Procedure duration 30 to 39 minutes
8.5
17.1
38
52
JN4BD
NOMESCO Finland
Extensive body CT
7.1
16.9
43
72
Z40.9
ICD-10 Finland
Prophylactic surgery, unspecified
+∞
16.9
16
*
A04AA55
ATC
palonosetron, combinations; systemic
9.9
16.4
33
38
HWA00
NOMESCO Finland
Repair of wound dehiscence in surgery of mammary gland
91.3
15.8
17
*
TPH07
NOMESCO Finland
Cathetrisation of artery
7.2
15.7
39
63
WB103
NOMESCO Finland
Simple adjuvant cytostatic therapy
10.0
15.5
31
35
A04AD12
ATC
aprepitant; systemic
16.6
15.2
24
16
HAD55
NOMESCO Finland
Incision of periprosthetic capsule of breast
+∞
14.7
14
*
L03AA13
ATC
pegfilgrastim; parenteral
9.0
14.6
31
39
HAD50
NOMESCO Finland
Removal of prosthetic implant from breast
45.6
14.3
17
*
1CD02
NOMESCO Finland
NA
32.3
14.1
18
6
L02BG04
ATC
letrozole; oral
5.8
14.1
41
82
N02BE01
ATC
paracetamol; systemic, rectal
5.5
13.7
218
1710
ZZQ00
NOMESCO Finland
Free microvascular graft of skin
27.7
13.6
18
7
ZXE50
NOMESCO Finland
More than nine and less than 12 hours
27.7
13.6
18
7
QBB05
NOMESCO Finland
Revision of wound of skin of trunk
42.7
13.3
16
*
LCD04
NOMESCO Finland
Laparoscopic hysterectomy
6.9
13.2
33
54
HA1TE
NOMESCO Finland
Supplementary or limited ultrasound examination of mammary glands
30.4
13.1
17
6
WX110
NOMESCO Finland
Local anesthesy
3.3
12.9
192
1369
ZX120
NOMESCO Finland
Intravenous
5.7
12.7
37
74
C50.81
ICD-10 Finland
Overall malignant tumor of the mammary gland, ductal tumor
21.5
12.7
18
9
HWH99
NOMESCO Finland
Other reoperation in surgery of mammary gland
+∞
12.6
12
*
R4120
NOMESCO Finland
Occupational therapy
6.7
12.5
32
54
ZXE03
NOMESCO Finland
Procedure duration 20 to 29 minutes
6.9
12.0
30
49
PD1BD
NOMESCO Finland
Extensive CT of abdominal aorta and branches
31.9
11.8
15
5
ZXM40
NOMESCO Finland
Use of fluorescent substance
+∞
11.5
11
*
TQW99
NOMESCO Finland
Other minor procedure on skin
7.1
11.5
28
44
C50.91
ICD-10 Finland
Malignant tumor in another specified localization in ductal mammary gland
16.1
11.5
18
12
8500/3-C50.4
ICD-O-3
Infiltrating duct carcinoma, NOS, of upper-outer quadrant of breast
8.8
11.4
24
30
C50.49
ICD-10 Finland
Malignant tumor of the upper outer quadrant of the mammary gland, other or undeterminated histology
18.2
11.4
17
10
Z50.8
ICD-10 Finland
Care involving use of other rehabilitation procedures
21.3
11.3
16
8
QBJ00
NOMESCO Finland
Liposuction in trunk
26.5
11.3
15
6
GA1AE
NOMESCO Finland
Ultrasound examination of thorax
26.5
11.3
15
6
ZX012
NOMESCO Finland
Radiotherapy with large shaped fields - isocentric therapy
7.0
11.0
27
43
C50.51
ICD-10 Finland
Malignant tumor of the lower outer quadrant of the mammary gland, ductal tumor
18.9
10.9
16
9
ZXD20
NOMESCO Finland
Day surgery
3.7
10.8
50
159
JFA98
NOMESCO Finland
Other transluminal endoscopic local operation on intestine
22.8
10.8
15
7
R2110
NOMESCO Finland
Giving the first information
4.7
10.8
37
89
N64.9
ICD-10 Finland
Disorder of breast, unspecified
15.2
10.7
17
12
HA013
NOMESCO Finland
Radiotherapy after total ablation of mammary gland
15.2
10.7
17
12
YG1BD
NOMESCO Finland
Extensive CT examination of thorax for dose design of radiotherapy
7.2
10.5
25
38
PJ3AT
NOMESCO Finland
Cytology of lymphnode with ultrasound guidance
19.9
10.4
15
8
A12AX
ATC
Calcium, combinations with vitamin D and/or other drugs
2.7
10.2
85
405
C50.31
ICD-10 Finland
Malignant tumor of the lower inner quadrant of the mammary gland, ductal tumor
21.1
9.9
14
7
ZXE02
NOMESCO Finland
Procedure duration 10 to 19 minutes
6.2
9.8
26
46
HAB40
NOMESCO Finland
Wedge excision of mammary gland
5.5
9.8
29
59
L02BG06
ATC
exemestane; oral
12.1
9.7
17
15
HA4AT
NOMESCO Finland
Labeling mammary gland pathology with ultrasound guidance
8.1
9.7
21
28
HA3AT
NOMESCO Finland
Pucture of mammary gland cyst with ultrasound examination
18.5
9.5
14
8
ZZS50
NOMESCO Finland
Insertion of tissue expander
104.0
9.5
10
*
LC2DE
NOMESCO Finland
Demanding ultrsound examination of uterus, parametrium and lower part of abdomen with speciel methods
4.9
9.5
31
71
HWD00
NOMESCO Finland
Reoperation for deep haemorrhage in surgery of mammary gland
22.8
9.5
13
6
D05.1
ICD-10 Finland
Intraductal carcinoma in situ
10.2
9.4
18
19
QB9S1
NOMESCO Finland
Photography of skin or subcutaneous tissue in torso, unspecified
38.3
9.1
11
*
I97.2
ICD-10 Finland
Postmastectomy lymphoedema syndrome
51.9
8.7
10
*
NK6QA
NOMESCO Finland
Measurement of bone density from tow or more locations with X-ray
5.8
8.7
24
45
L01BC06
ATC
capecitabine; oral
8.4
8.5
18
23
ZXE05
NOMESCO Finland
Procedure duration 40 to 49 minutes
5.6
8.4
24
47
ZZQ10
NOMESCO Finland
Free microvascular graft of skin and muscle
+∞
8.4
8
*
T81.0
ICD-10 Finland
Haemorrhage and haematoma complicating a procedure, not elsewhere classified
4.7
8.4
28
66
ZXD05
NOMESCO Finland
Urgent procedure
2.4
8.1
90
489
WB401
NOMESCO Finland
Simple antibody therapy of primary tumour
13.7
8.0
13
10
Y83
ICD-10 Finland
Surgical operation and other surgical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure
4.7
7.8
26
61
Z50.1
ICD-10 Finland
Other physical therapy
46.5
7.8
9
*
C50
ICD-10 Finland
Malignant neoplasm of breast
7.1
7.8
18
27
ZX112
NOMESCO Finland
Subcutaneous
12.4
7.7
13
11
L02AE03
ATC
goserelin; implant
9.3
7.7
15
17
WB123
NOMESCO Finland
Demanding adjuvant cytostatic therapy
26.0
7.6
10
*
B01AB04
ATC
dalteparin; parenteral
5.1
7.6
23
49
WB121
NOMESCO Finland
Demanding neoadjuvant cytostatic therapy
14.0
7.5
12
9
C50.42
ICD-10 Finland
Malignant tumor of the upper outer quadrant of the mammary gland, lobular tumor
14.0
7.5
12
9
Z80.8
ICD-10 Finland
Family history of malignant neoplasm of other organs or systems
82.6
7.5
8
*
J01DB01
ATC
cefalexin; oral
2.8
7.4
205
1687
QWF00
NOMESCO Finland
Reoperation for insufficiency of suture in plastic surgery of skin
+∞
7.3
7
*
HAD99
NOMESCO Finland
Other plastic operation on breast
16.4
7.3
11
7
S18
ICPC
Laceration/cut
2.2
7.3
95
553
HA6AA
NOMESCO Finland
Extra corporeal mammography of operated mammary gland
6.0
7.2
19
34
QBE10
NOMESCO Finland
Excision of other lesion extending through all layers of skin of trunk
4.4
6.7
23
56
XF603
NOMESCO Finland
Direct intraarterial blood pressure measurement
8.2
6.7
14
18
N63
ICD-10 Finland
Unspecified lump in breast
3.5
6.5
29
90
ZZS55
NOMESCO Finland
Distension of tissue expander
71.7
6.5
7
*
HAD00
NOMESCO Finland
Augmentation mammoplasty
71.7
6.5
7
*
M05BX04
ATC
denosumab; parenteral
8.5
6.4
13
16
Z08.7
ICD-10 Finland
Follow-up examination after combined treatment for malignant neoplasm
+∞
6.3
6
*
GD1AA
NOMESCO Finland
Thorax X-ray examination
2.1
6.2
84
489
X76
ICPC
Malignant neoplasm breast female
7.6
6.0
13
18
SPAT1324
SPAT
Screening procedure
0.4
6.0
21
508

Mortality – FinRegistry

This endpoint is excluded from FinRegistry analyses (omitted endpoint).

Relationships between endpoints

Index endpoint: Z21_PROPHYLACT_SURGE – Prophylactic surgery

GWS hits: -

This endpoint is excluded from FinRegistry analyses (omitted endpoint).