Variation in staging and treatment of local and regional breast cancer in the elderly.
Few studies of practice variation in the management of early breast cancer for elderly women have examined the process of care in depth.
This study evaluated the effects of age and other factors on surgical staging techniques and treatment.
Virginia cancer registry data were linked with Medicare claims and 1990 census data.
The sample included all newly diagnosed patients with pathologic confirmed local and regional breast cancer in 1985-1989 (n=3,361).
Analyses included descriptive univariate statistics and multiple logistic regression analysis for staging and treatment alternatives.
Process of care variables included tumor size determination, axillary lymph node dissection, use of adjuvant therapy, and radiation if breast conserving surgery (BCS) was performed.
About 75 percent of women had tumor size and axillary node dissection.
Increasing comorbidity was associated with a lower likelihood of axillary node dissection.
Nine percent of local compared to 44 percent of regional disease patients received adjuvant therapy.
Hormonal therapy increased from 13 percent of women in 1985-1988 to 24 percent in 1989.
Hormonal therapy did not vary with patient age.
One-third of the patients with positive lymph nodes compared to 8 percent of node negative women received hormonal therapy.
Blacks were more likely to present with advanced disease. (...)
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Femelle, Vieillard, Homme, Age, Stade clinique, Traitement, Rétrospective, Ganglion lymphatique, Traitement adjuvant, Chimiothérapie, Anticancéreux, Radiothérapie, Chirurgie conservatrice, Pratique professionnelle, Statut socioéconomique, Epidémiologie, Glande mammaire pathologie, Virginie, Etats Unis, Amérique du Nord, Amérique, Taille tumeur
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Female, Elderly, Human, Age, Clinical stage, Treatment, Retrospective, Lymph node, Adjuvant treatment, Chemotherapy, Antineoplastic agent, Radiotherapy, Conservative surgery, Professional practice, Socioeconomic status, Epidemiology, Mammary gland diseases, Virginia, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0427423
Code Inist : 002B20E02. Création : 10/04/1997.