Regional variation in breast cancer surgery: Results from the National Cancer Database (NCDB)

Abstract

BackgroundEarly studies have shown significant regional differences in the utilization of breast-conserving therapy (BCT) and mastectomy with reconstruction. It is expected that with the passage of time and the adoption of national treatment guidelines, these disparities would disappear. MethodsPatients with non-metastatic breast cancer who underwent surgery between 2004 and 2013 were analyzed using the National Cancer Database (NCDB). Trends in BCT and reconstruction were evaluated and multivariate logistic regression performed. ResultsThe highest rate of BCT was in New England (69%) and the lowest in East South Central (49%), p < 0.001. The rate of reconstruction was highest in the Middle Atlantic (44%) and the lowest in East South Central (26%), p < 0.001. Compared to East South Central, the odds ratio (OR) for BCT in New England was 2.2 (95% CI 2.1–2.3), and the OR for reconstruction in Middle Atlantic was 1.7 (95% CI 1.6–1.8). ConclusionThere continue to be significant regional differences in breast surgery.