Early Stage Breast Cancer in Older Women: Predictors and Outcomes of Therapy
Annual rept. 15 Sep 1997-14 Sep 1998
MEDICAL COLL OF WISCONSIN MILWAUKEE
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The goal of this project is to study the relationship of initial surgical treatment for breast cancer to specific outcomes. We have completed substantial work on the development of an algorithm to use Medicare data to identity women undergoing treatment for breast cancer. The specificity of the algorithm is 99.95 when using hospital claims, but 99.3 when using hospital and physician claims. By studying tumor registry patients in nine locations across the United States, we have determined that the rate of receipt of appropriate initial breast care defined as total mastectomy plus lymph node dissection, or breast-conserving surgery with radiotherapy and lymph node dissection has decreased by about 10 from 88 in 1990 to 78 by the end of 1995. This decrease in the percentage receiving appropriate therapy occurred in all age groups. It was more prominent among those residing in more urban areas, and appears attributable mostly to women undergoing breast-conserving surgery without radiotherapy or without lymph node dissection.
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