survival implications associated with variation in mastectomy rates for early-staged breast cancer生存的意义与乳房的变化利率早乳腺癌.pdfVIP

Hindawi Publishing Corporation International Journal of Surgical Oncology Volume 2012, Article ID 127854, 9 pages doi:10.1155/2012/127854 Research Article Survival Implications Associated with Variation in Mastectomy Rates for Early-Staged Breast Cancer John M. Brooks,1 Elizabeth A. Chrischilles,2 Mary Beth Landrum,3 Kara B. Wright,2 Gang Fang,4 Eric P. Winer,5 and Nancy L. Keating3, 6 1 College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA 2 College of Public Health, University of Iowa, Iowa City, IA 52242, USA 3 Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA 4 Eshelman School of Pharmacy, University of North Carolina, Chapell Hill, NC 27599, USA 5 Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02115, USA 6 Division of General Internal Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA 02120, USA Correspondence should be addressed to John M. Brooks, john-brooks@ Received 23 March 2012; Revised 23 May 2012; Accepted 25 June 2012 Academic Editor: Steven Heys Copyright © 2012 John M. Brooks et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Despite a 20-year-old guideline from the National Institutes of Health (NIH) Consensus Development Conference recommending breast conserving surgery with radiation (BCSR) over mastectomy for woman with early-stage breast cancer (ESBC) because it preserves the breast, recent evidence shows mastectomy rates increasing and higher-staged ESBC patients are more likely to receive mastectomy. These observations suggest that some pa