CB2-04: Use of the Oncology Beacon Module and VDW Data to Identify Variations in Treatment for Advanced Colorectal Cancer.
2012
152 HMORN 2012 – Selected Abstracts medical record abstraction. For this analysis, we included 2384 women with an incident diagnosis of stage 1-3 breast cancer with no history of chest radiation. We excluded cases of inflammatory or multifocal breast cancer. Results: We found rates of TM as the initial surgical procedure varied by study site (p<0.0001), age at diagnosis (p=0.0005), and by use of preoperative MRI (p<0.0001). TM frequency ranged from 10.4% - 21.0% across the four institutions. Increased TM use was associated with increasing pre-operatively estimated tumor size (p<0.0001), ER/PR negative status (p=0.0007), high grade (p<0.0001) and lobular (vs. ductal) carcinoma (p=0.001). We did not find TM increasing over time. When we limited our analysis to the 1712 cases with tumor size <20 mm, we continued to observe variability in initial TM frequency across institutions from 5.2% to 14.2% (p<0.0001). Discussion: Our TM rates were low compared to those reported in previous studies. Variation in TM rates was associated with several patient, tumor, and facility characteristics and may reflect differences in the patient population presenting with breast cancer, or in patients’ treatment preferences. This variation persisted even when limited to women with small tumors. While TM rates were relatively low, the two-fold variation by study site suggests inconsistent surgical practices across facilities despite several studies showing BCT and mastectomy provide equal survival benefit.
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