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Table 3 Chances of receiving multidisciplinary treatment

From: Regional variation in breast cancer treatment in the Netherlands and the role of external peer review: a cohort study comprising 63,516 women

Treatment

Hospital category

% of patients treated according to guidelines

OR

95% CI

  

‘90-‘95

‘96-‘01

‘02-‘07

‘08-‘10

  

Complete breast conserving treatment. N = 22453

Controls

95.6

92.3

93.4

95.8

1.00

Reference

Inclusion criteria: Stage I-IIIA

North High IP

97.8

97.1

97.8

98.3

2.68*

2.08-3.45

Exclusion criterium: Breast amputation after BCS

North Low IP

95.4

96.3

96.7

97.1

1.77*

1.43-2.17

 

Rotterdam High IP

93.0

88.9

91.9

96.7

0.77*

0.64-0.92

 

Rotterdam Low IP

94.6

89.6

91.7

95.0

0.72*

0.60-0.85

Introduction of the SNB. N = 25612

Controls

0

33.9

93.6

98.3

1.00

Reference

Inclusion criteria: cT1-2, cN0, cM0, BCS

North high IP

0

16.2

93.9

98.8

0.68*

0.55-0.84

 

North low IP

0

20.9

93.2

98.2

0.59*

0.50-0.70

Rotterdam high IP

0

19.1

89.0

98.8

0.46*

0.38-0.55

Rotterdam low IP

0

14.8

92.1

96.9

0.48*

0.40-0.57

Radiotherapy after BCS for DCIS. N = 2414

Controls

16.1

31.7

76.8

85.2

1.00

Reference

Inclusion criteria: DCIS, BCS

North high IP

50.0

49.0

74.8

84.9

1.24

0.88-1.74

 

North low IP

57.1

43.7

72.5

81.7

1.13

0.84-1.52

Rotterdam high IP

33.3

48.9

72.0

79.8

1.08

0.79-1.49

Rotterdam low IP

27.6

50.4

74.1

83.3

1.27

0.93-1.73

Adjuvant radiotherapy locally advanced breast cancer N = 1511

Controls

64.6

67.3

64.6

69.1

1.00

Reference

Inclusion criteria: cT3,anyN,M0 and any T,N2-3,M0 + amputation

North high IP

53.5

54.4

53.5

68.3

0.75

0.51-1.10

 

North low IP

46.2

62.5

46.2

53.2

0.56*

0.39-0.80

Rotterdam high IP

39.2

34.2

39.2

61.5

0.40*

0.29-0.55

Rotterdam low IP

29.7

35.9

29.7

68.6

0.36*

0.25-0.52

Adjuvant chemotherapy early stage breast cancer. N = 9511

Controls

51.3

73.1

85.1

91.9

1.00

Reference

Inclusion criteria: pT1-2 M0/X, surgery age < 60

North high IP

62.3

69.7

90.4

93.0

1.24

1.00-1.54

 

North low IP

52.8

70.6

91.4

91.3

1.29*

1.07-1.54

 

Rotterdam high IP

60.2

72.3

88.0

95.6

1.50*

1.26-1.81

Rotterdam low IP

55.3

67.2

90.1

96.0

1.22*

1.01-1.46

Neo-adjuvant chemotherapy T4/M0 breast cancer. N = 1484

Controls

5.1

27.4

34.5

61.9

1.00

Reference

Inclusion criteria: cT4NxM0, surgery

North high IP

11.2

25.0

56.0

65.3

1.24

0.73-2.09

 

North low IP

4.8

22.8

57.8

44.0

1.57*

1.00-2.47

 

Rotterdam high IP

6.7

28.0

55.0

51.9

2.67*

1.74-4.07

Rotterdam low IP

5.3

29.2

54.8

61.5

2.02*

1.32-3.08

  1. Odd’s ratio’s for receiving multidisciplinary therapy per hospital category. Adjusted for age, year of incidence, annual volume of diagnoses per hospital, stage (if necessary). 1990–2010 *P < 0.05. IP = implementation proportion of recommendations given in the programme.