title: Hospital volume differences and five-year survival from breast cancer.
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of hospital volume on long-term survival for women with breast cancer.
  
  
  METHODS
  Survival analysis and proportional-hazard modeling were used to assess 5-year survival and risk of death, adjusting for clinical and sociodemographic variables.
  
  
  RESULTS
  At 5 years, patients from very low-volume hospitals had a 60% greater risk of all-cause mortality than patients from high-volume hospitals.
  
  
  CONCLUSIONS
  Hospital volume of breast cancer surgical cases has a strong positive effect on 5-year survival. Research is needed to identify whether processes of care, especially postsurgical adjuvant treatments, contribute to survival differences.
authors.affiliation: New York State Department of Health, Albany, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Roohan
authors.forename: N A
authors.initials: NA
authors.lastname: Bickell
authors.forename: M S
authors.initials: MS
authors.lastname: Baptiste
authors.forename: G D
authors.initials: GD
authors.lastname: Therriault
authors.forename: E P
authors.initials: EP
authors.lastname: Ferrara
authors.forename: A L
authors.initials: AL
authors.lastname: Siu
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis; D015996:Survival Rate