Ellen P. McCarthy, PhD, MPH; Long H. Ngo, PhD; Richard G. Roetzheim, MD, MSPH; Thomas N. Chirikos, PhD; Donglin Li, MD, MPH; Reed E. Drews, MD; Lisa I. Iezzoni, MD, MSc
Disclaimer: Although this study used the linked SEER–Medicare database, the interpretation and reporting of these data are solely the authors' responsibility.
Acknowledgments: The authors acknowledge the efforts of several groups responsible for the creation and dissemination of the linked SEER–Medicare database, including the Applied Research Program, National Cancer Institute; the Office of Research, Development and Information, Centers for Medicare & Medicaid Services; Information Management Services, Inc.; and the SEER Program tumor registries. The authors thank Roger B. Davis, ScD, for his statistical assistance.
Grant Support: By the National Cancer Institute (RO1 CA100029).
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Ellen P. McCarthy, PhD, MPH, Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon Street, Suite 220, Brookline, MA 02444; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. McCarthy: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon Street, Suite 220, Brookline, MA 02444.
Drs. Ngo, Li, Drews, and Iezzoni: Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.
Dr. Roetzheim: University of South Florida, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612.
Dr. Chirikos: H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612.
Author Contributions: Conception and design: E.P. McCarthy, R.G. Roetzheim, L.I. Iezzoni.
Analysis and interpretation of the data: E.P. McCarthy, L.H. Ngo, R.G. Roetzheim, T.N. Chirikos, D. Li, R.E. Drews, L.I. Iezzoni.
Drafting of the article: E.P. McCarthy, L.I. Iezzoni.
Critical revision of the article for important intellectual content: E.P. McCarthy, R.G. Roetzheim, T.N. Chirikos, R.E. Drews, L.I. Iezzoni.
Final approval of the article: E.P. McCarthy, L.H. Ngo, R.G. Roetzheim, T.N. Chirikos, D. Li, R.E. Drews, L.I. Iezzoni.
Provision of study materials or patients: L.I. Iezzoni.
Statistical expertise: E.P. McCarthy, L.H. Ngo, T.N. Chirikos, D. Li, L.I. Iezzoni.
Obtaining of funding: E.P. McCarthy, L.I. Iezzoni.
Administrative, technical, or logistic support: L.H. Ngo, D. Li, R.E. Drews.
Collection and assembly of data: E.P. McCarthy, D. Li.
McCarthy EP, Ngo LH, Roetzheim RG, Chirikos TN, Li D, Drews RE, et al. Disparities in Breast Cancer Treatment and Survival for Women with Disabilities. Ann Intern Med. 2006;145:637-645. doi: 10.7326/0003-4819-145-9-200611070-00005
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Published: Ann Intern Med. 2006;145(9):637-645.
The 1990 National Institutes of Health (NIH) consensus statement (1) concluded that breast-conserving surgery with adjuvant radiotherapy is an acceptable alternative to mastectomy for most women with early-stage breast cancer. Randomized trials show that breast-conserving surgery with adjuvant radiotherapy is equal to mastectomy in survival and recurrence (2-6). Despite this, studies have repeatedly found that many women with traits that can suggest a social disadvantage—including older age (7-9), minority race or ethnicity (9-14), low socioeconomic status (income or education) ((7), (14-15)), rural residence ((8), (15)), and lack of health insurance (10)—do not receive breast-conserving surgery. Although several factors, including patients' preferences, could explain these disparities, concerns about substandard care persist.
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Hematology/Oncology, Breast Cancer.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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