Survival outcome of care by specialist surgeons in breast cancer: a study of 3786 patients in the west of Scotland.

摘要: Abstract Objective: To compare survival outcome for patients with breast cancer cared by specialist and non-specialist surgeons in a geographically defined area. Design: Retrospective study of all female aged under 75 years the area treated between 1980 June 1988 (before screening began). Patients were identified from registry pathology records hospitals Specialist one author. All other caring considered non-specialists. Setting: A population urban west Scotland. Subjects: 3786 histologically verified operated on 1 January 30 followed to 31 December 1993. Main measures: Five 10 year rates specialists non-specialists; relative hazard ratios derived Cox9s proportional hazards model adjusted prognostic factors—age, socioeconomic status, tumour size, nodal involvement. Results: The five rate was 9% higher 8% surgeons. reduction risk dying 16% (95% confidence interval 6% 25%) found after adjustment age, benefit care apparent age groups, small large tumours, tumours that did not affect nodes consistent across categories. Conclusions: Survival differences magnitude demonstrated have implications provision services treatment women cancer. There is need improve equity