Low use of breast conservation surgery in medically indigent populations

BACKGROUND: Breast conservation surgery (BCS) with radiation is an acceptab le treatment for early-stage breast cancer. METHODS: Data were obtained from hospital cancer registries on women surgic ally treated for Stage 0 to II breast cancer from 1993 to 1997, Data on 1,7 47 patients were analyzed for surgical treatment, hospital type (private ve rsus public), disease stage, and ethnic origin. RESULTS: In this study, 34% of women received BCS, Women treated in private hospitals received BCS more often than women treated in public hospitals. Women with stage II disease received BCS less often than women with earlier stage disease. Hospital type (public versus private) and disease stage wer e strong, independent predictors for use of BCS. When hospital type and dis ease stage were statistically controlled, no treatment differences across e thnic groups were identified. CONCLUSIONS: Use of BCS in this study was low compared with National Cancer Database statistics. Women treated in publicly funded hospitals and those with stage II disease were significantly less likely to receive BCS. Am J S urg. 1999;178: 470-474, (C) 1999 by Excerpta Medica, Inc.