title: Surgical treatment for women with breast cancer in relation to socioeconomic and insurance status.
abstract: Based on the National Breast Cancer Audit of the Royal Australasian College of Surgeons an association between patient age and type of breast cancer surgery received has already been demonstrated. The aim of this study is to assess the patterns of surgical treatment for women with early breast cancer in relation to socioeconomic and insurance status. Data on patient demographics, diagnostic, and surgical procedures and cancer characteristics in 115,872 episodes of early breast cancer reported to the National Breast Cancer Audit between 1998 and 2012 is used for this study. Tumor size, histologic grade, number of tumors, lymph node positivity, and lymphovascular invasion are the major prognostic factors adjusted for. Reconstruction following mastectomy is the most likely surgical procedure for the higher socioeconomic and privately insured patients. Mastectomy alone is the most likely surgical procedure for the lower socioeconomic and for public patients. No surgery is the most likely surgical outcome for the lower socioeconomic and the least likely for the higher socioeconomic population. Open biopsy is the most likely diagnostic procedure for the lower socioeconomic and fine needle aspiration for the higher socioeconomic population. Socioeconomic and insurance status, are both independently associated with the types of treatment and diagnostic procedure for women with breast cancer. Opportunities present to investigate an association of these factors with morbidity and survival outcomes.
authors.affiliation: Lyell McEwin Hospital, Division of Surgery, Adelaide, South Australia, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Azzopardi
authors.forename: David
authors.initials: D
authors.lastname: Walsh
authors.forename: Chilton
authors.initials: C
authors.lastname: Chong
authors.forename: Corey
authors.initials: C
authors.lastname: Taylor
mesh_terms: D001315:Australia; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D008408:Mastectomy; D009520:New Zealand; D012959:Socioeconomic Factors
keywords: breast cancer; insurance; socioeconomic status; surgery