Geographic variation in the treatment of localized breast cancer

Article Abstract:

Use of breast-conserving surgery to treat women with breast cancer that has not spread varies among different regions of the US. Data from the National Cancer Institute on the types of surgery used to treat 18,399 non-Hispanic white, 324 Hispanic and 1,174 black women with breast cancer in nine different regions of the US between 1983 and 1986 show variation in all age groups. The percentage of white women who had breast-conserving surgery varied from 9.2% in Iowa to 41.5% in Seattle, WA. The proportion of white women who received radiation therapy also was lowest in Iowa, and highest in Seattle, WA. The number of white women who had breast-conserving surgery and/or radiation therapy increased between 1983 and 1986, but the relative percentages of women who had these treatments in different regions remained approximately the same. Use of breast-conserving surgery to treat Hispanic and black women was approximately the same as for white women in different regions. Older women and black women in Atlanta, GA and Detroit, MI, however, were less likely than other women to receive radiation therapy after breast-conserving surgery.

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Treatment options for breast cancer - beyond survival

Article Abstract:

Advances in the understanding of breast cancer have changed treatment options for women with early stage breast cancer. Many of these women can be treated with breast-conserving surgery such as a lumpectomy, quadrantectomy or partial mastectomy rather than a radical mastectomy. Two research studies found that breast-conserving surgery is used to treat woman with early-stage breast cancer most often in the Northeast US, least often in the Southeast US and most often in the 17 states with informed consent laws. The use of breast-conserving surgery also was related to the type of hospital at which the patient was treated. These studies also found that use of breast-conserving surgery was lower in older women, and fewer older women who had breast-conserving surgery had radiation therapy. Surgeons' beliefs and practice methods, especially in providing information on treatment options, may affect the use of breast-conserving therapy. The effect of a radical mastectomy on a woman's quality of life should be weighed against the threat of cancer recurrence.

Editorial, Statistics, Informed consent (Medical law), Informed consent

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Body-mass index and mortality in Korean men and women

Article Abstract:

A 12-year prospective cohort study of Koreans between the ages of 35 and 90 years examined the association between body weight and the risk of death, including deaths from any cause and deaths from specific diseases in relation to the body-mass index (BMI). Results suggested that higher rates of death were observed in underweight, overweight, and obese men and women than men and women of normal weight, and the relation of death to BMI varied depending on the cause of death, age, sex and smoking history.

Health aspects, Analysis, Mortality, Risk factors, Obesity, Body mass index, Koreans

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