In-House Breast-Conserving Surgery Lower in VHA Facilities

TAMPA, FL — Looking just at procedures performed in house, rates of breast-conserving surgery (BCS) are much lower at the VHA than in the private sector, according to a new study led by researchers from the James A. Haley Veterans’ Hospital in Tampa.

Rates were more similar, however, when procedures performed by an outside facility but purchased by the VHA were taken into account, according to the study published recently in the American Journal of Surgery.

Based solely on procedures performed in the VHA, rates of BCS use are much lower in the VHA than in the private sector. We were able to show similar rates of BCS use when we accounted for procedures paid for by the VHA but performed at an outside facility.

The authors, noting that previous non-state-adjusted research found a lower use of BCS for breast cancer at VHA facilities, called for further exploration and prospective analyses to examine their findings.

For the study, researchers combined data from the VHA Centralized Cancer Registry with administrative datasets to describe surgical treatment for breast cancer in VHA facilities from 2000 to 2006.

The results indicated that, when considering only procedures performed in VHA facilities, BCS rates decreased from 50.5% (53/105) in 2000 to 42.3% (58/137) in 2006. After accounting for procedures conducted in the private sector and paid for by the VHA, BCS rates approached those of breast cancer patients receiving treatment outside of the VHA.

1Luther SL, Neumayer L, Henderson WG, Foulis P, Richardson M, Haun J, Mikelonis M, Rosen A. The use of breast-conserving surgery for women treated for breast cancer in the Department of Veterans Affairs. Am J Surg. 2013 Jul;206(1):72-9. doi: 10.1016/j.amjsurg.2012.08.012. Epub 2013 Apr 20. PubMed PMID: 23611837.

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