Despite recent data showing an overall decrease in mortality from breast cancer, breast cancer mortality rates remain high, particularly among older women. Geographic differences in the breast cancer mortality of older women appear at least partially attributable to survival differences, a finding which implicates cancer control practices. There is much evidence that older women with breast cancer receive less appropriate care than younger women. One factor, which has been shown to influence outcomes of some disease processes, is provider experience, usually measured as the volume of cases seen at a given hospital or handled by a given physician. In this application, we propose to investigate the relationship between breast cancer outcomes and provider volume of cases, in a cohort of older breast cancer patients.
The specific aims of this proposal are, among a cohort of SEER patients aged 65 and older, who were treated for early stage breast cancer and for whom Medicare claims are available, to: 1. Determine the treatment hospital and other relevant hospital characteristics (size, urban vs rural status, teaching status, availability of special facilities) for patients in the cohort treated at inpatient or outpatient hospital-based surgical centers. 2. Determine the treating surgeon and other relevant physician characteristics (age, year of medical school, graduation, gender, specialty and board certification). 3. Determine the annual volume of older breast cancer patients treated by each hospital and surgeon treating patients in the cohort. 4. Assess the relationship of annual hospital volume and annual surgeon volume to outcomes of overall 5-year survival, 5-year survival from breast cancer, and 5-year survival free of treatment of recurrent disease.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA081379-03
Application #
6513552
Study Section
Special Emphasis Panel (ZRG1-SNEM-4 (01))
Program Officer
Warren, Joan
Project Start
2000-07-01
Project End
2004-06-30
Budget Start
2002-08-28
Budget End
2004-06-30
Support Year
3
Fiscal Year
2002
Total Cost
$201,825
Indirect Cost
Name
Medical College of Wisconsin
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073134603
City
Milwaukee
State
WI
Country
United States
Zip Code
53226
Yen, Tina W F; Li, Jianing; Sparapani, Rodney A et al. (2016) The interplay between hospital and surgeon factors and the use of sentinel lymph node biopsy for breast cancer. Medicine (Baltimore) 95:e4392
Kong, Amanda L; Pezzin, Liliana E; Nattinger, Ann B (2015) Identifying patterns of breast cancer care provided at high-volume hospitals: a classification and regression tree analysis. Breast Cancer Res Treat 153:689-98
Yen, Tina W F; Laud, Purushuttom W; Sparapani, Rodney A et al. (2015) An algorithm to identify the development of lymphedema after breast cancer treatment. J Cancer Surviv 9:161-71
Neuner, Joan M; Zokoe, Nathan; McGinley, Emily L et al. (2014) Quality of life among a population-based cohort of older patients with breast cancer. Breast 23:609-16
Yen, Tina W F; Laud, Purushuttom W; Sparapani, Rodney A et al. (2014) Surgeon specialization and use of sentinel lymph node biopsy for breast cancer. JAMA Surg 149:185-92
Neuner, J M; Yen, T W; Sparapani, R A et al. (2011) Fracture risk and adjuvant hormonal therapy among a population-based cohort of older female breast cancer patients. Osteoporos Int 22:2847-55
Yen, Tina W F; Czypinski, Linda K; Sparapani, Rodney A et al. (2011) Socioeconomic factors associated with adjuvant hormone therapy use in older breast cancer survivors. Cancer 117:398-405
Kong, Amanda L; Yen, Tina W F; Pezzin, Liliana E et al. (2011) Socioeconomic and racial differences in treatment for breast cancer at a low-volume hospital. Ann Surg Oncol 18:3220-7
Yen, Tina W F; Sparapani, Rodney A; Guo, Changbin et al. (2010) Elderly breast cancer survivors accurately self-report key treatment information. J Am Geriatr Soc 58:410-2
Nattinger, Ann Butler; Pezzin, Liliana E; Sparapani, Rodney A et al. (2010) Heightened attention to medical privacy: challenges for unbiased sample recruitment and a possible solution. Am J Epidemiol 172:637-44

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