Abstract
Background This study was performed to evaluate variables that affect the use of mastectomy and lumpectomy in an underinsured population. Methods A retrospective review of all patients who underwent breast cancer operations from July 2001 to February 2011 at a safety net hospital was performed. Univariate and multivariate analyses were performed to identify variables, which were associated with the type of operation. Results Of the 412 patients, 81% of the patients were underinsured or uninsured. Most patients (58%) presented with clinical stage 2A/B disease. Mastectomy was performed in 37% of patients and lumpectomy in 63%. In multivariate analysis, clinical tumor size (P =.035) and pathologic stage (P =.003) remained associated with mastectomy, while use of preoperative chemotherapy (P =.004) and type of surgeon (P =.001) was associated with lumpectomy. Conclusions Most patients underwent lumpectomy despite later stage at presentation. Preoperative chemotherapy was associated with increased likelihood of lumpectomy. © 2015 Elsevier Inc.