NONCLINICAL FACTORS ASSOCIATED WITH SURGERY RECEIVED FOR TREATMENT OFEARLY-STAGE BREAST-CANCER

Background. Women diagnosed with early breast cancer have had the oppo rtunity to receive breast-conserving surgical treatment, which reduces the physical and psychological morbidity heretofore associated with b reast removal. Methods. Nonclinical factors associated with women rece iving partial mastectomies with radiation (P + R) compared with modifi ed radical mastectomies without radiation (MOR) were examined in 2238 Black and White women diagnosed, in 1985 through 1987, with early-stag e breast cancer in the metropolitan Detroit area. Results. Age at diag nosis and size of hospital were the strongest predictors of type of su rgery received, with younger women (less than 55 years of age) and wom en treated in larger hospitals (more than 500 beds) more than twice as likely to receive P + R. Stratifying on race, age at diagnosis remain ed the strongest predictor for White women, followed by hospital size. Among Black women, hospital size was more strongly associated with su rgery received than was age. Conclusions. Younger women and women unde rgoing treatment at large hospitals are more likely to receive the bre ast-conserving P + R. Black women treated in small hospitals appear to be particularly unlikely to receive P + R.