| Surgeon characteristics and variations in treatment for early-stage breast cancer. | |
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MedLine Citation:
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PMID: 17224496 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Mary Ann Gilligan; Joan Neuner; Rodney Sparapani; Purushottam W Laud; Ann B Nattinger |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 142 ISSN: 0004-0010 ISO Abbreviation: Arch Surg Publication Date: 2007 Jan |
Date Detail:
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Created Date: 2007-01-16 Completed Date: 2007-02-08 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: United States |
Other Details:
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Languages: eng Pagination: 17-22 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA. gilligan@mcw.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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R01 CA 81379/CA/NCI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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