Lymph-Node Negative Breast Cancer Survival Improved in Specialized Hospitals

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According to a recent article published in the journal Cancer, women with early breast cancer have significantly improved survival when treated in a hospital that treats a greater number of women with this stage of disease and/or in a hospital involved in research and teaching activities.

Lymph-node negative breast cancer refers to cancer that has not spread outside the breast. Overall cure rates for women diagnosed with lymph-node negative breast cancer are high following standard treatment approaches. However, a significant portion of these women experience a cancer recurrence and may ultimately succumb to their disease. Researchers have been focusing on cancer and patient characteristics that possibly define which women are at a higher risk of developing a recurrence. Findings may allow treatment strategies to be individualized and long-term outcomes improved.

One factor that appears associated with long-term survival is the institution at which a patient is treated. Several previous studies have indicated that patients often have improved outcomes if they receive treatment at an institution that treats a large volume of patients with their specific disease (high-volume) and/or are treated by a high-volume physician.

Researchers from Canada recently conducted a study to determine if an association exists between long-term outcomes and medical institutions at which women with lymph-node negative breast cancer are treated. This study included the review of outcomes of women treated at medical facilities that treated different volumes of patients with lymph-node negative breast cancer. Data from different types of medical facilities (i.e. teaching and research versus not) as also included. Overall, women treated at high-volume medical facilities and those treated at teaching or research facilities had significantly improved survival compared to women treated at low-volume hospitals and/or facilities not involved in research or teaching.

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Death rate was increased 70% for women treated at low-volume medical facilities (25 or fewer new cases of lymph-node negative breast cancer per year) compared to those treated at high-volume medical facilities (100 or more new cases per year).
Death rate was increased 44% and 30%, respectively, for women treated at facilities that treated 25-49 new cases per year and 50-99 new cases per year.
Death rate was decreased by 30% in medical institutions involved in research, teaching, or those with onsite radiation facilities

The researchers concluded that women with node-negative breast cancer have significantly improved survival if treated in high-volume hospitals and/or hospitals involved in teaching, research, or those that have onsite radiation facilities. Patients diagnosed with lymph-node negative breast cancer may wish to ask their physician about patient-volume for their stage of disease at the treating facility, as well as the institution’s involvement in teaching and research and radiation facilities.

Reference: Hebert-Croteau N, Brisson J, Lemiaire J, et al. Investigating the correlation between hospital of primary treatment and survival of women with breast cancer. Cancer. 2005;104:1343-1348.