1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

VARIABLE QUALITY OF CARE FOR BREAST CANCER PATIENTS.

The outcome of breast cancer is better when the diagnosis is made early and when management includes evaluation of hormone-receptor levels and specific interventions (such as radiation therapy and adjuvant chemotherapy) for patients with different stages of the disease. However, two studies suggest that many patients do not receive optimal care and that the quality of care varies among both patients and institutions.

One study analyzed cancer-registry data on 5766 newly diagnosed cases of breast cancer from 99 Illinois hospitals. The data showed that late diagnoses (at stages IIb through IV) tended to occur in urban hospitals that had more poorly insured patients, fewer breast cancer cases, and lower oncology charges. These institutions also frequently omitted hormone-receptor testing and post-mastectomy radiation therapy. A second study analyzed data on 8095 women with stage I or II breast cancer from the cancer registry of the Seattle-Puget Sound region, and found that the likelihood of breast-conserving surgery was lower with advancing age, stage II disease, and residence outside an urban area, but increased with education or income.

These two studies indicate that hospitals' practices in managing breast cancer are highly divergent and are often influenced by patients' socioeconomic status.

— THL

Published in Journal Watch General Medicine January 7, 1992

Citation(s):

Lazovich D et al. Underutilization of breast-conserving surgery and radiation therapy among women with stage I or II breast cancer. JAMA 1991 Dec 25 266 3433-3438.

• Medline abstract (Free)

Hand R et al. Hospital variables associated with quality of care for breast cancer patients. JAMA 1991 Dec 25 266 3429-3432.

• Medline abstract (Free)