Specialisation and Breast Cancer Survival
Author Information
Author(s): D. Kingsmore, A. Ssemwogerere, D. Hole, C. Gillis
Primary Institution: University of Glasgow
Hypothesis
Does the survival advantage associated with specialist treatment of breast cancer persist after the introduction of screening?
Conclusion
The survival advantage associated with specialist treatment has persisted with longer-term follow-up and is also apparent in the postscreening cohort of women.
Supporting Evidence
- The percentage of women treated by specialists increased from 11% to 59% over the study period.
- 5-year survival improved from 60% in the prescreening era to 73% in the postscreening era.
- Specialist treatment showed a relative hazard ratio of 0.83 in the prescreening era and 0.89 in the postscreening era.
Takeaway
This study found that women treated by specialist surgeons for breast cancer tend to live longer, even after screening programs were introduced.
Methodology
The study analyzed survival patterns of women with invasive breast cancer diagnosed between 1980 and 1994, comparing treatment outcomes between specialist and nonspecialist surgeons.
Potential Biases
Potential biases include lead-time and length-time biases due to differences in tumor detection methods.
Limitations
The definition of 'specialisation' was subjective and based on local surgeons' opinions, which may not be universally applicable.
Participant Demographics
Women aged under 75 years with histologically proven invasive breast cancer.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI=0.53–0.62
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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