Treating early-stage breast cancer: hospital characteristics associated with breast-conserving surgery

Women's choices between the options of breast-conserving surgery or mastectomy for breast cancer appear to be unrelated to medical indication. Researchers analyzed trends in breast cancer surgery between 1981 and 1987 for 500 U.S. hospitals. There were 87,449 cases of early stage disease. The percentage of radical mastectomies declined from 8.7% to 2.3%. The number of modified radical mastectomies and simple mastectomies remained about the same, ranging from 74.6% to 78.4% and 6.9% to 5.5%, respectively. Breast-conserving surgery rates rose from 9.9% to a peak of 15.7% in 1986 and declined to 14.5% in 1987. Those more likely to choose breast-conserving surgery tended be less less than 50 years old, have private insurance, are non-White, have the surgery in an urban hospital, have the surgery at a hospital with more than 250 beds, and have the surgery at a teaching hospital as opposed to a hospital with no teaching program or a university-based medical center.