Was breast conserving surgery underutilized for early stage breast cancer? Instrumental variables evidence for stage II patients from Iowa

John M Brooks; Elizabeth A Chrischilles; Shane D Scott; Shari S Chen-Hardee

doi:10.1111/j.1475-6773.2003.00184.x

Back

Was breast conserving surgery underutilized for early stage breast cancer? Instrumental variables evidence for stage II patients from Iowa

Journal article

Open access

Peer reviewed

Was breast conserving surgery underutilized for early stage breast cancer? Instrumental variables evidence for stage II patients from Iowa

John M Brooks, Elizabeth A Chrischilles, Shane D Scott and Shari S Chen-Hardee

Health services research, Vol.38(6 Pt 1), pp.1385-1402

12/2003

DOI: 10.1111/j.1475-6773.2003.00184.x

PMCID: PMC1360955

PMID: 14727779

Files and links (1)

url

https://doi.org/10.1111/j.1475-6773.2003.00184.xView

Published (Version of record) Open Access

Abstract

To estimate the average survival effects of breast conserving surgery plus irradiation relative to mastectomy for marginal stage II breast cancer patients in Iowa from 1989-1994. DATA SOURCES/DATA SETTING: Secondary linked Iowa SEER Cancer Registry--Iowa Hospital Association discharge abstract data for women in Iowa with stage II breast cancer from 1989-1994. Observational instrumental variables (IV) analysis. Women with stage II breast cancer from the Iowa SEER Cancer Registry 1989-1994 who received all of their inpatient care in Iowa were linked with their respective hospital discharge abstracts. Breast conserving surgery plus irradiation decreased survival relative to mastectomy for marginal stage II breast cancer patients in Iowa during the early 1990s. In this study marginal patients were those whose surgery choices were affected by differences in area treatment rates and access to radiation facilities. If marginal patients are representative of patients whose treatment choices would be affected by changes in treatment rates, an increase in the breast conserving surgery plus irradiation rate for stage II early stage breast cancer patients would have decreased survival in Iowa during the early 1990s. Further research with newer data and broader samples is needed to make more current and specific assessments.

Breast Neoplasms - surgery

SEER Program

Humans

Combined Modality Therapy

Health Services Research

Mastectomy, Segmental - utilization

Breast Neoplasms - radiotherapy

Iowa

Breast Neoplasms - pathology

Survival Analysis

Female

Health Services Misuse - statistics & numerical data

Aged

Mastectomy - utilization

Neoplasm Staging

Details

Title: Subtitle: Was breast conserving surgery underutilized for early stage breast cancer? Instrumental variables evidence for stage II patients from Iowa
Creators: John M Brooks - Health Effectiveness Research Center, College of Pharmacy and the College of Public Health, University of Iowa, Iowa City 52242, USA
Elizabeth A Chrischilles
Shane D Scott
Shari S Chen-Hardee
Resource Type: Journal article
Publication Details: Health services research, Vol.38(6 Pt 1), pp.1385-1402
Publisher: United States
DOI: 10.1111/j.1475-6773.2003.00184.x
PMID: 14727779
PMCID: PMC1360955
ISSN: 0017-9124
eISSN: 1475-6773
Grant note: N01-PC-85063-20 / NCI NIH HHS
Language: English
Date published: 12/2003
Academic Unit: Pharmacy; Epidemiology
Record Identifier: 9983995147702771

Metrics

16 Record Views

56 Times Cited - Web of Science

See more details