OUTCOMES OF OLDER WOMEN WITH EARLY STAGE BREAST CANCER

描述（申请人摘要）：尽管最近的数据显示总体上 乳腺癌死亡率下降，乳腺癌死亡率仍然 高，尤其是老年妇女。乳房的地理差异 老年妇女的癌症死亡率似乎至少部分归因于 生存差异，这一发现暗示了癌症控制的做法。 有很多证据表明，患有乳腺癌的老年妇女 比年轻女性更好的照顾。 有一个因素已经被证明会影响一些疾病的结果 流程，是提供者的经验，通常以所看到的案例数量来衡量 在给定的医院或由给定的医生处理。在本申请中，我们 建议调查乳腺癌结果与 提供者的病例量，在一个队列的老年乳腺癌患者。的 这项建议的具体目标是，在一组65岁的SEER患者中， 老年人，谁是治疗早期乳腺癌和医疗保险， 索赔可提供给：1。确定治疗医院等 相关医院特征（规模、城市与农村状况、教学 状态，特殊设施的可用性） 在住院或门诊医院为基础的外科中心。2.确定 治疗外科医生和其他相关医生特征（年龄、 医学院、毕业、性别、专业和委员会认证）。3. 确定老年乳腺癌患者的年治疗量， 医院和外科医生治疗队列中的患者。4.评估 年医院数量和年外科医生数量与 总体5年生存率、乳腺癌5年生存率和 无复发性疾病治疗的存活率。

DESCRIPTION (Applicant's abstract): Despite recent data showing an overall decrease in mortality from breast cancer, breast cancer mortality rates remain high, particularly among older women. Geographic differences in the breast cancer mortality of older women appear at least partially attributable to survival differences, a finding which implicates cancer control practices. There is much evidence that older women with breast cancer receive less appropriate care than younger women. One factor, which has been shown to influence outcomes of some disease processes, is provider experience, usually measured as the volume of cases seen at a given hospital or handled by a given physician. In this application, we propose to investigate the relationship between breast cancer outcomes and provider volume of cases, in a cohort of older breast cancer patients. The specific aims of this proposal are, among a cohort of SEER patients aged 65 and older, who were treated for early stage breast cancer and for whom Medicare claims are available, to: 1. Determine the treatment hospital and other relevant hospital characteristics (size, urban vs rural status, teaching status, availability of special facilities) for patients in the cohort treated at inpatient or outpatient hospital-based surgical centers. 2. Determine the treating surgeon and other relevant physician characteristics (age, year of medical school, graduation, gender, specialty and board certification). 3. Determine the annual volume of older breast cancer patients treated by each hospital and surgeon treating patients in the cohort. 4. Assess the relationship of annual hospital volume and annual surgeon volume to outcomes of overall 5-year survival, 5-year survival from breast cancer, and 5-year survival free of treatment of recurrent disease.