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Am J Surg. 2013 Sep;206(3):393-9. doi: 10.1016/j.amjsurg.2013.01.034. Epub 2013 Jul 16.

Breast conserving surgery versus mastectomy: the influence of comorbidities on choice of surgical operation in the Department of Defense health care system.

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1
John P. Murtha Cancer Center, Bethesda, MD, USA.

Abstract

BACKGROUND:

Studies on the effect of comorbidities on breast cancer operation have been limited and inconsistent. This study investigated whether pre-existing comorbidities influenced breast cancer surgical operation in an equal access health care system.

METHODS:

This study was based on linked Department of Defense cancer registry and medical claims data. The study subjects were patients diagnosed with stage I to III breast cancer during 2001 to 2007. Logistic regression was used to determine if comorbidity was associated with operation type and time between diagnosis and operation.

RESULTS:

Breast cancer patients with comorbidities were more likely to receive mastectomy (odds ratio [OR] = 1.27; 95% confidence interval [CI], 1.14 to 1.42) than breast conserving surgery plus radiation. Patients with comorbidities were also more likely to delay having operation than those without comorbidities (OR = 1.27; 95% CI, 1.14 to 1.41).

CONCLUSIONS:

In an equal access health care system, comorbidity was associated with having a mastectomy and with a delay in undergoing operation.

KEYWORDS:

Breast cancer; Breast conserving surgery; Comorbidity; Department of Defense health system; Mastectomy; Military

PMID:
23866763
PMCID:
PMC4148911
DOI:
10.1016/j.amjsurg.2013.01.034
[Indexed for MEDLINE]
Free PMC Article
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