Geographic variation in the use of breast-conserving treatment for breast cancer
Article Abstract:
Differences in the use of breast-conserving surgery to treat breast cancer patients in different regions of the US cannot be explained by differences in hospital characteristics. Of 36,982 65- to 79-year-old female Medicare patients with breast cancer that had not spread or had spread only regionally into the lymph nodes, 12.1% underwent breast-conserving surgery; 87.9% underwent some type of total mastectomy. The percentage of women who underwent breast-conserving surgery varied from 3.5% in Kentucky to 21.2% in Massachusetts. Use of breast-conserving surgery was significantly higher in the New England and Middle Atlantic states, and significantly lower in the South Atlantic, South Central, and West North Central states. Women were more likely to undergo breast-conserving surgery in urban hospitals, in teaching hospitals, in larger hospitals and in hospitals with radiation therapy facilities, geriatric services or a cancer center. Variation in treatment of breast cancer patients in different regions remained after taking into account differences in hospital characteristics.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1992
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Effect of Nancy Reagan's mastectomy on choice of surgery for breast cancer by US women
Article Abstract:
Celebrities can have a significant effect on health behavior in the US. Analysis of data on approximately 160,000 American women with breast cancer who were treated in the 1980's reveals that fewer women chose breast-conserving surgery following the decision by Nancy Reagan to have a modified radical mastectomy. This drop in the use of breast-conserving surgery, also called a lumpectomy, occurred just after Mrs. Reagan was treated in Oct, 1987. It lasted throughout the first quarter of 1988 and then returned to previous levels. Mrs. Reagan's decision was widely criticized in the media.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1998
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The effect of legislative requirements on the use of breast-conserving surgery
Article Abstract:
State governments should probably think twice before passing legislation to influence physicians' behavior. Researchers analyzed the use of breast-conserving therapy by women in Michigan, Georgia, New Mexico and Hawaii after these states passed laws requiring women to be given information about this treatment. The use of breast-conserving treatment in these states increased 6% to 13% in the 3 to 12 months following the passage of the law, but these rates dropped back down to the rate in states without such legislation shortly after.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
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