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Arch Surg. 2007 Jan;142(1):17-22.

Surgeon characteristics and variations in treatment for early-stage breast cancer.

Author information

1
Department of Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA. gilligan@mcw.edu

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.

PMID:
17224496
DOI:
10.1001/archsurg.142.1.17
[Indexed for MEDLINE]

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