PREDICTORS OF BREAST-CONSERVING SURGERY IN CONNECTICUT, 1990-1992

Background: Breast-conserving surgery (BCS) has been recommended for m ost early-stage primary breast cancers, but predictors may vary by tim e and geographic area. Methods: Among 5,266 early-stage female breast cancers (diagnosed in 1990-1992) in the population-based Connecticut T umor Registry, the poverty rate of census tract of residence (an ecolo gic indicator of socioeconomic status), age at diagnosis, race, marita l status, extent of disease, year of diagnosis, and town of residence were analyzed in relation to BCS use. Results: The poverty rate of cen sus tract was not a statistically significant variable in logistic reg ression analyses of BCS use; however, age, year of diagnosis, and stag e at diagnosis were predictors. Residence in a town with a hospital ha ving radiotherapy facilities or near a university hospital were not pr edictors of BCS use. High BCS rates (69-94% vs. 49% statewide) were fo und for residents of a cluster of seven contiguous towns associated wi th a single (nonuniversity) hospital. Conclusions: BCS was not associa ted with poverty level of area of residence but continued to be lower for larger or node-positive cancers. Attitudes and practices of local physicians were hypothesized as being important in explaining variatio n in BCS use by town of residence.