Investigating the correlation between hospital of primary treatment and the survival of women with breast cancer

Hébert‐Croteau, Nicole; Brisson, Jacques; Lemaire, Jácques; Latreille, Jean; Pineault, Raynald

doi:10.1002/cncr.21336

Cited by 51 publications

(44 citation statements)

References 33 publications

(41 reference statements)

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“…No significant differences in total or surgical subscores were observed between patients operated by surgeons in the intermediate (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) …”

Section: Resultsmentioning

confidence: 99%

“…Characteristics of both patients and health care providers [8] have been related to these variations. Hospital and physician volume [9], specialization [10,11], participation in research [9], multidisciplinary teams [12] and treatment in accordance to guidelines [13] have been found to affect both the way patients are cared for and the outcomes. Variations in treatment include type of breast and axillary surgery, and use of chemotherapy, hormone therapy and radiation therapy.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of state-of-the-art management of early breast cancer in Switzerland

et al. 2011

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Background: The aim of this study was to investigate predictors of state-of-the-art management of early breast cancer in Switzerland. Patients and methods:The study included 3499 women aged 25-79 years diagnosed with invasive breast cancer stages I-IIIA in [2003][2004][2005]. Patients were identified through population-based cancer registries and treated in all kinds of settings. Concordance with national and international recommendations was assessed for 10 items covering surgery, radiotherapy, systemic adjuvant therapy and histopathology reporting. We used multivariate logistic regression to identify independent predictors of high (10 points) and low (£7 points) concordance.Results: In one-third of the patients, management met guidelines in all items, whereas in about one-fifth, three or more items did not comply. Treatment by a surgeon with caseload in the upper tercile and team involved in clinical research were independent predictors of a high score, whereas treatment by a surgeon with a caseload in the lower tercile was associated with a low score. Socioeconomic characteristics such as income and education were not independent predictors, but patient's place of residence and age independently predicted management according to recommendations.Conclusion: Specialization and involvement in clinical research seem to be key elements for enhancing the quality of early breast cancer management at population level.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of state-of-the-art management of early breast cancer in Switzerland

et al. 2011

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“…Surgeon and hospital factors may also play a role. Surgeon preferences, surgeon and hospital volume and hospital teaching status have been found to be associated with type of surgery and may also be associated with survival [22][23][24]. Further investigation into these factors is merited, as results may have potential for policy implications.…”

Section: Discussionmentioning

confidence: 99%

Survival in stage I–III breast cancer patients by surgical treatment in a publicly funded health care system

Fisher¹,

Gao²,

Yasui³

et al. 2015

Annals of Oncology

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Background: Recent investigations of breast cancer survival in the United States suggest that patients who receive mastectomy have poorer survival than those who receive breast-conserving surgery (BCS) plus radiotherapy, despite clinically established equivalence. This study investigates breast cancer survival in the publicly funded health care system present in Alberta, Canada.Patients and methods: Surgically treated stage I-III breast cancer cases diagnosed in Alberta from 2002 to 2010 were included. Demographic, treatment and mortality information were collected from the Alberta Cancer Registry. Unadjusted overall and breast cancer-specific mortality was assessed using Kaplan-Meier and cumulative incidence curves, respectively. Cox proportional hazards models were used to calculate stage-specific mortality hazard estimates associated with surgical treatment received.Results: A total of 14 939 cases of breast cancer (14 633 patients) were included in this study. The unadjusted 5-year all-cause survival probabilities for patients treated with BCS plus radiotherapy, mastectomy, and BCS alone were 94% (95% CI 93% to 95%), 83% (95% CI 82% to 84%) and 74% (95% CI 70% to 78%), respectively. Stage II and III patients who received mastectomy had a higher all-cause (stage II HR = 1.36, 95% CI 1.13-1.48; stage III HR = 1.74, 95% CI 1.24-2.45) and breast cancer-specific (stage II HR = 1.39, 95% CI 1.09-1.76; stage III HR = 1.79, 95% CI 1.21-2.65) mortality hazard compared with those who received BCS plus radiotherapy, adjusting for patient and clinical characteristics. BCS alone was consistently associated with poor survival.Conclusions: Stage II and III breast cancer patients diagnosed in Alberta, Canada, who received mastectomy had a significantly higher all-cause and breast cancer-specific mortality hazard compared with those who received BCS plus radiotherapy. We suggest greater efforts toward educating and encouraging patients to receive BCS plus radiotherapy rather than mastectomy when it is medically feasible and appropriate.

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“…The fi eld of quality assurance has been promulgated to improve outcomes by ensuring specifi c elements deemed to constitute and indicate quality care. To measure quality of medical care, it is fi rst necessary to defi ne a feasible and acceptable minimal standard of care, which must allow acceptable levels of variation in treatment outcomes as well as critical determinant variables [22,23]. For example, recent trials of adjuvant therapy for rectal cancer incorporated these concepts by training and auditing surgeons performing total mesorectal excisions [24].…”

Section: Discussionmentioning

confidence: 99%