To investigate the frequency of breast-sparing treatment among breast cancer patients subsequently enrolled in national cooperative group studies of adjuvant chemotherapy.
A data base was formed of 5,172 patients randomized onto two intergroup trials.
Lumpectomy rates were analyzed within study-defined risk strata and across geographic regions.
Significant predictors of lower lumpectomy usage were determined in multivariate analyses with variables that described patient and disease characteristics, systemic risk strata, geographic region, and socioeconomic indicators based on zipcode of residence.
Breast-conservation rates were 30% in the node-negative and 15% in the node-positive trials, with a wide geographic variation within each study (range, 14% to 49% and 9% to 31%, respectively).
Lumpectomy use declined with increasing tumor size and did not exceed 40% even for tumors ¾ 1 cm with negative nodes.
With increasing risk of systemic relapse, frequency of lumpectomy declined (rates for five strata in order of increasing systemic risk : 41%, 33%, 24%, 18%, and 11%), even though these strata were not known at the time of the surgical decision.
A logistic model confirmed the joint significance of geographic region and systemic risk. (...)
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Chirurgie conservatrice, Modalité traitement, Statut socioéconomique, Age, Niveau étude, Région géographique, Stade clinique, Epidémiologie, Etats Unis, Amérique du Nord, Amérique, Homme, Femelle, Glande mammaire pathologie
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Conservative surgery, Application method, Socioeconomic status, Age, Education level, Geographical division, Clinical stage, Epidemiology, United States, North America, America, Human, Female, Mammary gland diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0016635
Code Inist : 002B20E02. Création : 21/05/1997.