Factors which affect the use of lumpectomy and mastectomy in an underinsured, safety net hospital population

Anne E. Klemens, Lyndsay Olsen-Deeter, Chiu-Hsieh Hsu, Marcia E. Bouton, Brano Djenic, Lisa M. Winton, Ian K. Komenaka

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background This study was performed to evaluate variables that affect the use of mastectomy and lumpectomy in an underinsured population. Methods A retrospective review of all patients who underwent breast cancer operations from July 2001 to February 2011 at a safety net hospital was performed. Univariate and multivariate analyses were performed to identify variables, which were associated with the type of operation. Results Of the 412 patients, 81% of the patients were underinsured or uninsured. Most patients (58%) presented with clinical stage 2A/B disease. Mastectomy was performed in 37% of patients and lumpectomy in 63%. In multivariate analysis, clinical tumor size (P =.035) and pathologic stage (P =.003) remained associated with mastectomy, while use of preoperative chemotherapy (P =.004) and type of surgeon (P =.001) was associated with lumpectomy. Conclusions Most patients underwent lumpectomy despite later stage at presentation. Preoperative chemotherapy was associated with increased likelihood of lumpectomy.

Original languageEnglish (US)
Pages (from-to)985-991
Number of pages7
JournalAmerican Journal of Surgery
Volume209
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Safety-net Providers
Segmental Mastectomy
Mastectomy
Population
Multivariate Analysis
Drug Therapy
Breast Neoplasms

Keywords

  • Breast conservation
  • Ethnicity
  • Lumpectomy
  • Minority
  • Preoperative chemotherapy
  • Race

ASJC Scopus subject areas

  • Surgery

Cite this

Factors which affect the use of lumpectomy and mastectomy in an underinsured, safety net hospital population. / Klemens, Anne E.; Olsen-Deeter, Lyndsay; Hsu, Chiu-Hsieh; Bouton, Marcia E.; Djenic, Brano; Winton, Lisa M.; Komenaka, Ian K.

In: American Journal of Surgery, Vol. 209, No. 6, 01.06.2015, p. 985-991.

Research output: Contribution to journalArticle

Klemens, Anne E. ; Olsen-Deeter, Lyndsay ; Hsu, Chiu-Hsieh ; Bouton, Marcia E. ; Djenic, Brano ; Winton, Lisa M. ; Komenaka, Ian K. / Factors which affect the use of lumpectomy and mastectomy in an underinsured, safety net hospital population. In: American Journal of Surgery. 2015 ; Vol. 209, No. 6. pp. 985-991.
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AU - Hsu, Chiu-Hsieh

AU - Bouton, Marcia E.

AU - Djenic, Brano

AU - Winton, Lisa M.

AU - Komenaka, Ian K.

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AB - Background This study was performed to evaluate variables that affect the use of mastectomy and lumpectomy in an underinsured population. Methods A retrospective review of all patients who underwent breast cancer operations from July 2001 to February 2011 at a safety net hospital was performed. Univariate and multivariate analyses were performed to identify variables, which were associated with the type of operation. Results Of the 412 patients, 81% of the patients were underinsured or uninsured. Most patients (58%) presented with clinical stage 2A/B disease. Mastectomy was performed in 37% of patients and lumpectomy in 63%. In multivariate analysis, clinical tumor size (P =.035) and pathologic stage (P =.003) remained associated with mastectomy, while use of preoperative chemotherapy (P =.004) and type of surgeon (P =.001) was associated with lumpectomy. Conclusions Most patients underwent lumpectomy despite later stage at presentation. Preoperative chemotherapy was associated with increased likelihood of lumpectomy.

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