Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

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 PMID: 17267725 PMCID: PMC1805003

Pubmed ID

17267725

Abstract

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 AB

Authors

Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Ann B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin
Joan Neuner MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin
Rodney Sparapani PhD Assistant Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-33847700092   42 Citations

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 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
jenkins-FCD Prod-332 f92a19b0ec5e8e1eff783fac390ec127e367c2b5