Low rate of breast conservation surgery in a large urban hospital serving the medically indigent

BACKGROUND: Breast conservation surgery (BCS) with radiation therapy is an acceptable treatment for stage I and II breast carcinoma. The purpose of th is study was to measure the use of BOS in a large, urban, university-affili ate hospital serving primarily medically indigent patients. METHODS: A chart review of patients receiving operative treatment for breas t carcinoma during 1995 and 1996 was done. Patients with stage I or II dise ase were selected. Data were analyzed for clinical stage, surgical treatmen t, age, and ethnic origin. RESULTS: Of patients eligible, only 16% received BCS. There were slight tre nds for younger women to receive BCS and for decreased use of BCS with stag e II disease. No differences in surgical treatment were seen across ethnic groups. CONCLUSIONS: We suggest that poverty, poor education, and cultural differen ces may play a role in selection of surgical treatment for breast carcinoma . Further investigation is needed to facilitate best treatment. Am J Surg. 1998;176:520-524. (C) 1998 by Excerpta Medica, Inc.