Hospital volume differences and five-year survival from breast cancer

Am J Public Health. 1998 Mar;88(3):454-7. doi: 10.2105/ajph.88.3.454.


Objectives: 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.

MeSH terms

  • Aged
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Female
  • Hospitals / statistics & numerical data*
  • Humans
  • Middle Aged
  • New York / epidemiology
  • Risk Factors
  • Socioeconomic Factors
  • Survival Analysis
  • Survival Rate