ArticleAnnals of surgery2018
The Effect of Hospital Volume on Breast Cancer Mortality.
Article in Annals of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The requirements of a specialist breast centre.Breast (Edinburgh, Scotland) · 2020Guideline
- The Managing Cancer and Living Meaningfully (CALM) Intervention Alleviates Chemotherapy-Related Cognitive Impairment in Patients with Breast Cancer by Modulating Pan-Immune-Inflammation Values.Integrative cancer therapiesTrial
- Associations of surgical breast cancer treatment at regional or community hospitals with patient-reported experience measures.Breast cancer research and treatment · 2026Article
- Use of Complementary and Alternative Medicine in the Management of Breast Cancer.JAMA network open · 2026Article
- Differences in Breast Cancer Care Between Rural Women Undergoing Treatment at a Referral Center and Those Treated Locally.Annals of surgical oncology · 2026Article
- Comparison of Survival Outcomes Among Women With Breast Cancer Across Different Health Systems in Veracruz, Mexico.Cureus · 2026Article
- Radiation De-Escalation in Older Women with Early-Stage ER+/HER2- Invasive Breast Cancer.Annals of surgical oncology · 2026Article
- Impact of bilateral surgery on time to treatment in patients with breast cancer undergoing mastectomy - a retrospective cohort study.BMC cancer · 2025Article
- Organizational Resources in Rare Cancer Outcomes: Survival Analysis After Surgery for Pheochromocytoma and Paraganglioma.Cancers · 2025Article
- Association between hospital volume and survival in patients with locally advanced breast cancer.Breast cancer research and treatment · 2025Article
- Influence of geographical accessibility to specialist and primary care givers on excess mortality of multiple sclerosis patients in France.BMC neurology · 2025Observational
- Decision-Making Patterns for Clinically Node-Positive, Hormone Receptor-Positive, HER2-Negative Early Breast Cancer: Insights From a Survey of Breast Cancer Experts.Journal of breast cancer · 2025Article
- Association of Surgeon Volume with Adherence to American Society of Breast Surgeons Surgical Quality Measures.Annals of surgical oncology · 2025Article
- Development and validation of a preoperative nomogram for predicting residual tumor risk in breast cancer patients undergoing excisional biopsy.Translational cancer research · 2025Article
- National Variation in Implementation of Sentinel Lymph Node Biopsy for Clinically Node-Positive Patients Undergoing Neoadjuvant Therapy.Annals of surgical oncology · 2025Article
- What Changes are Mandatory in Breast Surgery Training? An International Survey and Recommendations of the French Academy of Surgery and the Senologic International Society.European journal of breast health · 2025Article
- Article
- Low Hospital Volume Is Associated with Higher All-Cause Mortality in Black Women with Triple Negative Breast Cancer.Journal of racial and ethnic health disparities · 2024Article
- American College of Surgeons Operative Standards and Breast Cancer Outcomes.JAMA network open · 2024Article
- Urban-Rural Differences in Receipt of Cancer Surgery at High-Volume Hospitals and Sensitivity to Hospital Volume Thresholds.JCO oncology practice · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveThe aim of this study was to determine whether hospital volume was associated with mortality in breast cancer, and what thresholds of case volume impacted survival.
backgroundPrior literature has demonstrated improved survival with treatment at high volume centers among less common cancers requiring technically complex surgery.
methodsAll adults (18 to 90 years) with stages 0-III unilateral breast cancer diagnosed from 2004 to 2012 were identified from the American College of Surgeons National Cancer Data Base (NCDB). A multivariable Cox proportional hazards model with restricted cubic splines was used to examine the association of annual hospital volume and overall survival, after adjusting for measured covariates. Intergroup comparisons of patient and treatment characteristics were conducted with X and analysis of variance (ANOVA). The log-rank test was used to test survival differences between groups. A multivariable Cox proportional hazards model was used to estimate hazard ratios (HRs) associated with each volume group.
resultsOne million sixty-four thousand two hundred and fifty-one patients met inclusion criteria. The median age of the sample was 60 (interquartile range 50 to 70). Hospitals were categorized into 3 groups using restricted cubic spline analysis: low-volume (<148 cases/year), moderate-volume (148 to 298 cases/year), and high-volume (>298 cases/year). Treatment at high volume centers was associated with an 11% reduction in overall mortality for all patients (HR 0.89); those with stage 0-I, ER+/PR+ or ER+/PR- breast cancers derived the greatest benefit.
conclusionsTreatment at high volume centers is associated with improved survival for breast cancer patients regardless of stage. High case volume could serve as a proxy for the institutional infrastructure required to deliver complex multidisciplinary breast cancer treatment.
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