Trends in, and predictors of, breast-conserving surgery and radiotherapy for breast cancer in Connecticut, 1988-1997

Purpose: To describe the trends in, and predictors of, use of breast-conserving surgery (BCS) vs. mastectomy and use of post-BCS radiotherapy (RT), from 1988 through 1997 among residents of Connecticut. Methods and Materials: Data on surgical and RT procedures for 16,676 women diagnosed with early-stage (localized to the breast or with regional lymph node involvement) invasive breast cancer in 1988-1997 were obtained from the population-based Connecticut Tumor Registry. Results: Use of BCS (vs. mastectomy) increased over time and was lower for patients with nodal involvement or larger tumors. The absence of RT facilities at the hospital of first admission was negatively associated with BCS but not with post-BCS RT. Post-BCS RT was low among patients diagnosed at age 80+ years but increased over time only in this age group. Conclusion: Absence of RT at the hospital may be a deterrent to BCS. The temporal increase in post-BCS RT among patients diagnosed at age greater than or equal to80 years suggests changes in physicians' attitudes and/or patient preferences that require further study. (C) 2002 Elsevier Science Inc.