Predictors of breast-conserving surgery in Connecticut, 1990–1992

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Abstract
Background: Breast-conserving surgery (BCS) has been recommended for most early-stage primary breast cancers, but predictors may vary by time and geographic area. Methods: Among 5,266 early-stage female breast cancers (diagnosed in 1990–1992) in the population-based Connecticut Tumor Registry, the poverty rate of census tract of residence (an ecologic indicator of socioeconomic status), age at diagnosis, race, marital status, extent of disease, year of diagnosis, and town of residence were analyzed in relation to BCS use. Results: The poverty rate of census tract was not a statistically significant variable in logistic regression analyses of BCS use; however, age, year of diagnosis, and stage at diagnosis were predictors. Residence in a town with a hospital having radiotherapy facilities or near a university hospital were not predictors of BCS use. High BCS rates (69–94% vs. 49% statewide) were found for residents of a cluster of seven contiguous towns associated with a single (nonuniversity) hospital. Conclusions: BCS was not associated with poverty level of area of residence but continued to be lower for larger or node-positive cancers. Attitudes and practices of local physicians were hypothesized as being important in explaining variation in BCS use by town of residence.