Low rate of breast conservation surgery in a large urban hospital serving the medically indigent

Background: Breast conservation surgery (BCS) with radiation therapy is an acceptable treatment for stage I and II breast carcinoma. The purpose of this study was to measure the use of BCS in a large, urban, university-affiliated hospital serving primarily medically indigent patients. Methods: A chart review of patients receiving operative treatment for breast carcinoma during 1995 and 1996 was done. Patients with stage I or II disease were selected. Data were analyzed for clinical stage, surgical treatment, age, and ethnic origin. Results: Of patients eligible, only 16% received BCS. There were slight trends for younger women to receive BCS and for decreased use of BCS with stage II disease. No differences in surgical treatment were seen across ethnic groups. Conclusions: We suggest that poverty, poor education, and cultural differences may play a role in selection of surgical treatment for breast carcinoma. Further investigation is needed to facilitate best treatment.