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Treating early-stage breast cancer: hospital characteristics associated with breast-conserving surgery.

M E Johantgen, R M Coffey, D R Harris, H Levy and J J Clinton

Agency for Health Care Policy and Research, Center for General Health Services Intramural Research, Rockville, MD 20852, USA.

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.

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