title: Treating early-stage breast cancer: hospital characteristics associated with breast-conserving surgery.
abstract: Despite growing acceptance of the fact that women with early-stage breast cancer have similar outcomes with lumpectomy plus radiation as with mastectomy, many studies have revealed the uneven adoption of such breast-conserving surgery. Discharge data from the Hospital Cost and Utilization Project, representing multiple payers, locations, and hospital types, demonstrate increasing trends in breast-conserving surgery as a proportion of breast cancer surgeries from 1981 to 1987. Women with axillary node involvement were less likely to have a lumpectomy, even though consensus recommendations do not preclude this form of treatment when local metastases are present. Non-White race, urban hospital location, and hospital teaching were associated with an increased likelihood of having breast-conserving surgery.
authors.affiliation: Agency for Health Care Policy and Research, Center for General Health Services Intramural Research, Rockville, MD 20852, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Johantgen
authors.forename: R M
authors.initials: RM
authors.lastname: Coffey
authors.forename: D R
authors.initials: DR
authors.lastname: Harris
authors.forename: H
authors.initials: H
authors.lastname: Levy
authors.forename: J J
authors.initials: JJ
authors.lastname: Clinton
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006302:Health Services Research; D006742:Hospital Bed Capacity; D006769:Hospitals, General / Q000145:classification / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D015409:Mastectomy, Radical / Q000706:statistics & numerical data* / Q000639:trends; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data* / Q000639:trends; D015413:Mastectomy, Simple / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D014481:United States / Q000453:epidemiology