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Vidyya, from the Sanskrit "vaidya," a practitioner who has come to understand the science of life.

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Back To Vidyya Despite US NIH Recommendations

Breast Conserving Surgery Rates Still Low


 

A clinical research study released today reveals significant differences in the way U.S. hospitals manage breast cancer. Women at the nation's top-performing hospitals are more likely to undergo breast-conserving surgery (BCS) such as lumpectomy, compared to similar patients at other hospitals, according to the study from the Solucient Leadership Institute, formerly the HCIA-Sachs Institute. The National Institutes of Health recommended BCS for eligible patients over 10 years ago.

The study also finds that:

  • Compared to patients in the Northeast, women in the South are 21 percent less likely to receive BCS, and women in the West are 17 percent less likely.
  • Forty-six percent of Hispanic women undergo BCS, compared to 47.5 percent of African-American women, 48.5 percent of Asian Americans, and 51.1 percent of Whites.
  • Women insured by Medicaid are 69 percent less likely than privately insured patients to receive immediate breast reconstruction following mastectomy.
  • Immediate reconstructive surgery following mastectomy is more common in top-performing hospitals and teaching hospitals compared to community hospitals.
  • When it comes to radiation therapy following BCS, patients are most likely to undergo this treatment in top-performing hospitals, as well as in hospitals in the Western region; moreover, younger patients are more likely than older patients to receive post-BCS radiation.

"The good news is that top-performing hospitals are clearly leading the industry in providing more progressive initial treatment and follow up of breast cancer," says Jean Chenoweth, executive director of the Solucient Leadership Institute.

"However, an additional area of concern identified in this study is that women on Medicaid are significantly less likely to have immediate reconstructive surgery than privately insured women," Chenoweth adds. "This underscores the fact that women with breast cancer may not be being offered the same options, and that some treatments may not reflect best practice and follow-up care."

According to the National Cancer Institute, one in 10 U.S. women who live to age 80 will develop breast cancer in their lifetime. More alarming, breast cancer remains the most common cause of cancer death among women between ages 35 and 54. However, when detected early and treated appropriately, breast cancer victims may expect a five-year survival rate of 95 percent. The two major surgical approaches to treating breast cancer are BCS and mastectomy.

The purpose of the study, "100 Top Hospitals' Clinical Research Program: Management of Breast Cancer," was to examine how top-performing 100 Top Hospitals compare with other hospitals in each of three outcomes: use of BCS, use of radiation therapy following BCS, and the performance of immediate breast reconstruction following mastectomy.

Data from the following sources were compared in the study: the MedPar database, Solucient's proprietary all payer data base, the Health Care Financing Administration's Standard Analytical Files (SAF), and data from winners of the 100 Top Hospitals award, a strictly empirical evaluation of clinical and financial performance.


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Editor: Susan K. Boyer, RN
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