Low use of breast conservation surgery in medically indigent populations

Background: Breast conservation surgery (BCS) with radiation is an acceptable treatment for early-stage breast cancer. Methods: Data were obtained from hospital cancer registries on women surgically treated for Stage 0 to II breast cancer from 1993 to 1997. Data on 1,747 patients were analyzed for surgical treatment, hospital type (private versus public), disease stage, and ethnic origin. Results: In this study, 34% of women received BCS. Women treated in private hospitals received BCS more often than women treated in public hospitals. Women with stage II disease received BCS less often than women with earlier stage disease. Hospital type (public versus private) and disease stage were strong, independent predictors for use of BCS. When hospital type and disease stage were statistically controlled, no treatment differences across ethnic groups were identified. Conclusions: Use of BCS in this study was low compared with National Cancer Database statistics. Women treated in publicly funded hospitals and those with stage II disease were significantly less likely to receive BCS.