Hospital volume was significantly associated with processes of breast cancer care measures addressing diagnosis and treatment, a study published in the journal Cancer has shown.1
Variations in delivery of several breast cancer processes of care may be associated with reduced survival and a higher risk of disease recurrence.
To determine the extent to which hospital volume explains this variation, researchers analyzed data from 573,571 women with stage I to III unilateral breast cancer who were treated at 1755 different hospitals between 2007 and 2011. Of those, 38%, 51%, and 10% were treated at high-volume, medium-volume, and low-volume hospitals, respectively.
After controlling for sociodemographic characteristics, treatment year, and geographic location, results showed that hospital volume was significantly predictive for cancer diagnosis by initial biopsy, negative surgical margins, and appropriate locoregional treatment.
Researchers found that patients treated at high-volume hospitals were 30% (odds ratio [OR], 1.30; 95% CI, 1.14-1.49) more likely to have their diagnosis made on initial biopsy compared with those treated at low-volume hospitals.
In addition, patients who received care at high-volume facilities had a 28% (OR, 1.28; 95% CI, 1.13-1.44) higher likelihood of having negative surgical margins and a 16% (OR, 1.16; 95% CI, 1.09-1.24) higher odds of receiving the appropriate locoregional treatment.
The findings suggest that employing these processes to a broader group of hospitals could potentially improve the overall quality of care and outcomes of patients with breast cancer.
1. Yen TW, Pezzin LE, Li J, Sparapani R, Laud PW, Nattinger AB. Effect of hospital volume on processes of breast cancer care: a National Cancer Data Base study. Cancer. 2016 Nov 8. doi: 10.1002/cncr.30413. [Epub ahead of print]