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1.
Am J Surg ; 209(6): 985-91, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25457245

RESUMO

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.


Assuntos
Neoplasias da Mama/cirurgia , Mastectomia Segmentar/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde , Provedores de Redes de Segurança , Adulto , Negro ou Afro-Americano , Idoso , Arizona , Neoplasias da Mama/economia , Neoplasias da Mama/etnologia , Feminino , Hispânico ou Latino , Humanos , Modelos Logísticos , Mastectomia/economia , Mastectomia/estatística & dados numéricos , Mastectomia Segmentar/economia , Pessoa de Meia-Idade , Grupos Minoritários , Análise Multivariada , Razão de Chances , Estudos Retrospectivos , População Branca
2.
Surg Oncol ; 23(4): 186-91, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25443563

RESUMO

BACKGROUND: Despite no difference in overall survival between breast conservation and mastectomy, significant variation exists between institutions and within populations. Less data exists about racial and ethnic minority populations. The current study was performed to evaluate variables that affect use of breast conservation and mastectomy in an underinsured Hispanic population. METHODS: A retrospective review was performed of all patients who self-identified as of Hispanic ethnicity and underwent breast cancer operations from July 2001 to February 2011 at a safety net hospital. Sociodemographic, clinical, and treatment variables were evaluated. All patients with documented contraindications to breast conservation were excluded. Univariate analysis and multivariate analysis were performed to identify variables which were associated with type of operation. RESULTS: The average age of the 219 patients included was 50 years. Most of the patients (93%) were insured with Medicaid or uninsured and 59% presented with clinical stage 2A/B cancers. Mastectomy was performed in 33% of patients and 67% had breast conservation. In adjusted multivariate analysis higher pathologic stage (p=0.01) and English speakers (p=0.03) were associated with mastectomy. By contrast, higher BMI (p=0.03) and use of preoperative chemotherapy (p=0.01) were associated with breast conservation. CONCLUSIONS: In this underinsured Hispanic population, patients with higher pathologic stage and English speaking patients were more likely to undergo mastectomy. Patients who underwent preoperative chemotherapy and who had higher BMI were more likely to undergo breast conservation.


Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Hispânico ou Latino , Mastectomia Segmentar/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde , Tratamentos com Preservação do Órgão/estatística & dados numéricos , Adulto , Arizona , Índice de Massa Corporal , Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante , Feminino , Humanos , Idioma , Mamografia/estatística & dados numéricos , Medicaid , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Estudos Retrospectivos , Estados Unidos
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