title: Trends in surgical treatment of breast cancer at an urban teaching hospital: a six-year review.
abstract: The treatment of breast cancer at an urban teaching hospital from 1990 to 1995 was analyzed according to age, stage, race, and funding status. Two hundred thirty-eight patients (mean age, 55 years) with newly diagnosed breast cancers were retrospectively identified and reviewed. A larger proportion of all funded patients (F; n = 131) presented with early-stage cancers (ductal carcinoma in situ, stage I) compared to nonfunded (NF, n = 107) (41 vs 25%; P = 0.03). Additionally, there was an increasing rate of early cancers occurring in F over the study interval (40% in 1990 to 69% in 1995), but there was no such increase in NF. There was an increasing trend in the overall use of breast conservation therapy (BCT) over this interval (11.6% of all cancers in 1990, 50.8% in 1994 and 1995). Although F were overall more likely to undergo BCT than NF (40% vs 29%, P = 0.04), there was no statistical difference in the use of BCT for nonadvanced (ductal carcinoma in situ, stage I and II) cancers (44% of F, 46% of NF). Age did not affect the overall use of BCT (36% of patients 55 or older, 35% younger than 55). Mean age was significantly greater in F than in NF (60 vs 49, P < 0.000001), but racial composition did not differ between these two groups. In conclusion, funded status of our patients corresponded with earlier diagnosis, perhaps due to better access to screening. Additionally, neither funding status nor age affected the use of BCT in our patients with nonadvanced cancers. Our rate of BCT far exceeds that seen nationally, perhaps reflecting a trend at academic institutions.
authors.affiliation: Department of Surgery, University of Florida Health Science Center, Jacksonville 32209, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Arnold
authors.forename: E R
authors.initials: ER
authors.lastname: Frykberg
authors.forename: J W
authors.initials: JW
authors.lastname: Kilkenny
authors.forename: G J
authors.initials: GJ
authors.lastname: Bowers
authors.forename: J
authors.initials: J
authors.lastname: Mierzejewski
mesh_terms: D001741:Black or African American; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002278:Carcinoma in Situ / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery*; D005260:Female; D005431:Florida; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007348:Insurance, Health; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data / Q000639:trends*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies