Faculty Collaboration Database

Surgeon characteristics and variations in treatment for early-stage breast cancer. Arch Surg 2007 Jan;142(1):17-22

Date

01/17/2007

Pubmed ID

17224496

DOI

10.1001/archsurg.142.1.17

Scopus ID

2-s2.0-33846195316 (requires institutional sign-in at Scopus site)   45 Citations

Abstract

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.

Author List

Gilligan MA, Neuner J, 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 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

Aged
Breast Neoplasms
Female
Guideline Adherence
Humans
Lymph Node Excision
Male
Mastectomy, Segmental
Medicare
Middle Aged
Practice Guidelines as Topic
Practice Patterns, Physicians'
SEER Program
United States