Document Detail


Surgeon characteristics and variations in treatment for early-stage breast cancer.
MedLine Citation:
PMID:  17224496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Adherence to National Institutes of Health consensus statement recommendations for early-stage breast cancer will vary by surgeon characteristics. DESIGN: Secondary data analysis using the Surveillance, Epidemiology, and End Results national tumor registry linked with Medicare claims data. Logistic regression was used to analyze data on a cohort of 1045 surgeons who operated on 9449 Medicare patients with early-stage breast cancer. MAIN OUTCOME MEASURE: Care adherent to the 1990 National Institutes of Health consensus statement recommendations. RESULTS: Surgeon age and specialty were not associated with adherent care overall, nor among breast-conserving surgery or mastectomy subgroups. Patients of higher-volume surgeons were significantly more likely to undergo adherent care overall because of greater use of lymph node dissection among women who received either breast-conserving surgery or mastectomy. Patients of female surgeons and surgeons with a medical school affiliation were less likely to undergo adherent care overall, which was related to greater use of breast-conserving surgery and lesser use of lymph node dissection among patients who underwent breast-conserving surgery. CONCLUSIONS: Several surgeon characteristics are significantly associated with variations in breast cancer treatment received. These results warrant further investigation into the association between these surgeon characteristics and cancer care outcomes.
Authors:
Mary Ann Gilligan; Joan Neuner; Rodney Sparapani; Purushottam W Laud; Ann B Nattinger
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  142     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-16     Completed Date:  2007-02-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  17-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA. gilligan@mcw.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Breast Neoplasms / surgery*
Female
Guideline Adherence
Humans
Lymph Node Excision / statistics & numerical data
Male
Mastectomy, Segmental / statistics & numerical data
Medicare / statistics & numerical data
Middle Aged
Physician's Practice Patterns*
Practice Guidelines as Topic
SEER Program
United States
Grant Support
ID/Acronym/Agency:
R01 CA 81379/CA/NCI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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