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

Am J Public Health. 1995 Oct;85(10):1432-4. doi: 10.2105/ajph.85.10.1432.


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.

MeSH terms

  • Aged
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Female
  • Health Services Research
  • Hospital Bed Capacity
  • Hospitals, General / classification
  • Hospitals, General / statistics & numerical data*
  • Hospitals, Teaching
  • Humans
  • Mastectomy, Radical / statistics & numerical data*
  • Mastectomy, Radical / trends
  • Mastectomy, Segmental / statistics & numerical data*
  • Mastectomy, Segmental / trends
  • Mastectomy, Simple / statistics & numerical data*
  • Mastectomy, Simple / trends
  • Middle Aged
  • United States / epidemiology