Early Stage Breast Cancer in Older Women: Predictions and Outcomes of Therapy
Abstract
This study uses secondary data bases (SEER tumor registry records and Medicare claims data) to examine the relationship of primary breast cancer treatment to specific outcomes. We have found that the proportion of U.S. women with early stage breast cancer who are receiving appropriate care (defined by NIH Consensus statement) declined from 88% in 1983-89 to 78% by the end of 1995. This decline has occurred because the proportion of all women who were treated by breast-conserving surgery increased, and because women undergoing breast-conserving surgery are more likely to receive inappropriate care. We have now shown that patients living 15 or more miles from a hospital with radiotherapy facilities are less likely than others to undergo BCS therapy. Women living 40 or more miles from a radiotherapy site are less likely than others to undergo radiotherapy after a BCS procedure. Although BCS has undergone substantial adoption during the 1900's, women of higher socioeconomic status and who reside in urban areas remain more likely to undergo BCS. Compared to BCS patients who undergo radiotherapy, those BCS patients who do not undergo radiotherapy have a significantly elevated hazard ratio of treatment for recurrent disease. In addition, BCS patients who receive neither axillary lymph node dissection nor radiotherapy are at significantly higher risk of death, after adjusting for age, tumor size, and comorbid conditions.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2000
- Accession Number
- ADB267627
Entities
People
- Ann B. Nattinger
Organizations
- Medical College of Wisconsin