Breast cancer care faulted in community hospitals

By Amy Norton

NEW YORK (Reuters Health) - Women who have advanced breast cancer treated in a local community hospital appear to have a lower long-term survival rate than their counterparts treated at academic medical centers, a new study indicates.

The researchers say the reason, at least in part, seems to be that community hospitals are not making full use of proven, life-extending treatments.

A number of studies have found that the survival rates after fairly high-risk surgeries are better in so-called teaching hospitals. These centers are usually affiliated with a nearby medical school and, compared with community hospitals, often see a higher volume of patients and have more manpower and resources.

The current study looked at whether teaching hospitals also have better outcomes when it comes to long-term breast cancer survival, which depends not only on a woman's initial surgery but her overall care.

Researchers found that among nearly 25,000 women treated at Florida hospitals between 1994 and 2000, those who received care at a teaching hospital were more likely to be alive 5 to 10 years later.

Among women treated at one of eight academic centers, 84 percent and 72 percent were alive 5 and 10 years later, respectively. Those figures were 81 percent and 69 percent at busy "high volume" community hospitals, and 77 percent and 63 percent at smaller community hospitals, the researchers report in the Annals of Surgery.

The difference was mainly seen among women with more advanced breast cancer.

For example, for women with breast cancer that had spread to distant sites in the body, the 5-year survival rate of those treated in a teaching hospital was 47 percent, versus 25 percent among those treated at a community hospital.