TREATING EARLY-STAGE BREAST-CANCER - HOSPITAL CHARACTERISTICS ASSOCIATED WITH BREAST-CONSERVING SURGERY

Despite growing acceptance of the fact that women with early-stage bre ast cancer have similar outcomes with lumpectomy plus radiation as wit h mastectomy, many studies have revealed the uneven adoption of such b reast-conserving surgery. Discharge data from the Hospital Cost and Ut ilization Project, representing multiple payers, locations, and hospit al types, demonstrate increasing trends in breast-conserving surgery a s a proportion of breast cancer surgeries from 1981 to 1987. Women wit h axillary node involvement were less likely to have a lumpectomy, eve n though consensus recommendations do not preclude this form of treatm ent when local metastases are present. Non-White race, urban hospital location, and hospital teaching were associated with an increased like lihood of having breast-conserving surgery.