Relationship between number of breast cancer operations performed and 5-year survival after treatment for early-stage breast cancer. Am J Public Health 2007 Mar;97(3):539-44
Date
02/03/2007Pubmed ID
17267725Pubmed Central ID
PMC1805003DOI
10.2105/AJPH.2005.075663Scopus ID
2-s2.0-33847700092 (requires institutional sign-in at Scopus site) 49 CitationsAbstract
OBJECTIVES: We examined the association between number of breast cancer operations performed in a hospital (hospital volume) and all-cause and breast cancer-specific mortality using a national database and statistical methods appropriate for clustering and reducing confounding.
METHODS: In a retrospective cohort study, we linked Surveillance, Epidemiology, and End Results tumor registry data with Medicare claims data. The cohort included 11225 Medicare patients who had undergone surgery for early-stage breast cancer from 1994 to 1996 in 457 different hospitals. Primary outcomes were all-cause and breast cancer-specific survival rates at a mean follow-up time of 62.5 months.
RESULTS: In comparison with treatment in a low-volume hospital, treatment in a high-volume hospital was associated with hazard ratios of 0.83 (95% confidence interval [CI]=0.75, 0.92) for all-cause mortality and 0.80 (CI=0.66, 0.97) for breast cancer-specific mortality.
CONCLUSIONS: An association between the volume of breast cancer operations performed in a hospital and 5-year survival rates was observed for both all-cause and breast cancer-specific mortality. Further work investigating the aspects of hospital volume that contribute to increased survival is warranted.
Author List
Gilligan MA, Neuner J, Zhang X, Sparapani R, Laud PW, Nattinger ABAuthors
Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of WisconsinAnn B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin
Joan Neuner MD, MPH Professor in the Medicine department at Medical College of Wisconsin
Rodney Sparapani PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Breast Neoplasms
Cause of Death
Cluster Analysis
Female
Humans
Mastectomy
Mastectomy, Segmental
Medicare
Neoplasm Staging
Proportional Hazards Models
Risk Assessment
SEER Program
Surgery Department, Hospital
Survival Analysis
United States