Accession Number : ADB267627


Title :   Early Stage Breast Cancer in Older Women: Predictions and Outcomes of Therapy


Descriptive Note : Annual rept. 15 Sep 1999-14 Sep 2000


Corporate Author : MEDICAL COLL OF WISCONSIN MILWAUKEE


Personal Author(s) : Nattinger, Ann B


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/b267627.pdf


Report Date : Oct 2000


Pagination or Media Count : 118


Abstract : This study uses secondary data bases (SEER tumor registry records and Medicare claims data) to examine the relationship of primary breast cancer treatment to specific outcomes. We have found that the proportion of U.S. women with early stage breast cancer who are receiving appropriate care (defined by NIH Consensus statement) declined from 88% in 1983-89 to 78% by the end of 1995. This decline has occurred because the proportion of all women who were treated by breast-conserving surgery increased, and because women undergoing breast-conserving surgery are more likely to receive inappropriate care. We have now shown that patients living 15 or more miles from a hospital with radiotherapy facilities are less likely than others to undergo BCS therapy. Women living 40 or more miles from a radiotherapy site are less likely than others to undergo radiotherapy after a BCS procedure. Although BCS has undergone substantial adoption during the 1900's, women of higher socioeconomic status and who reside in urban areas remain more likely to undergo BCS. Compared to BCS patients who undergo radiotherapy, those BCS patients who do not undergo radiotherapy have a significantly elevated hazard ratio of treatment for recurrent disease. In addition, BCS patients who receive neither axillary lymph node dissection nor radiotherapy are at significantly higher risk of death, after adjusting for age, tumor size, and comorbid conditions.


Descriptors :   *BREAST CANCER , *RADIOTHERAPY , *PREDICTIONS , *WOMEN , MEDICAL SERVICES , DEATH , SURGERY , SOCIOLOGY , URBAN AREAS , MAMMARY GLANDS , STATISTICAL ANALYSIS , ECONOMICS , MEDICARE , DATA BASES , RATIOS


Subject Categories : Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE