REPORTS FROM THE FIELD
Study finds low rate of breast-conserving surgery
10 years later, few heed NIH advice
A clinical study released by the Solucient Leadership Institute in Evanston, IL, finds that 10 years after the National Institutes of Health in Bethesda, MD, recommended breast-conserving surgery (BCS) for eligible patients, only women at the nation’s top-performing hospitals receive less invasive procedures. In addition, the report reveals wide variance in the treatment of breast cancer based on geographic and demographic variables.
Specifically, Solucient found that:
- Women in Southern states are 21% less likely to receive BCS and women in the Western states are 17% less likely to receive BCS than women in the Northeast.
- 46% of Hispanic women receive BCS compared to 47.5% of African-American women, 48.5% of Asian American women, and 51.1% of White women.
- Women insured by Medicaid are 69% less likely than privately insured women to receive immediate breast reconstruction following mastectomy.
- Immediate reconstructive surgery following mastectomy is more common in teaching hospitals than in community hospitals.
- Patients are more likely to receive radiation therapy following BCS in top-performing hospitals, as well as in hospitals in the Western United States.
- Younger patients are more likely to receive radiation following BCS than older patients.
"An area of concern identified in this study is that women on Medicaid are significantly less likely to have immediate reconstructive surgery than privately insured women," notes Jean Chenoweth, executive director of the Solucient Leadership Institute. "This underscores the fact that women with breast cancer may not be offered the same options, and that some treatments may not reflect best practice and follow-up care."
The study, "100 Top Hospitals’ Clinical Research Program: Management of Breast Cancer," compared the performance of 100 top performing hospitals as identified by Solucient, formerly the HCIA-Sachs Institute, to other hospitals on each of the following three outcomes:
- use of BCS;
- use of radiation therapy following BCS;
- performance of immediate breast reconstruction following mastectomy.
Excerpts from the study and ordering information are available on the institute’s Web site at www.100tophospitals.com.
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