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Women’s health & midwifery
Provider-level characteristics are significantly associated with the increased likelihood of mastectomy over conservative surgery among elderly women with breast cancer
  1. Mahzabin Ferdous1,
  2. Tanvir C Turin1,2
  1. 1 Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta‎, Canada
  2. 2 Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  1. Correspondence to Dr Tanvir C Turin, University of Calgary, Calgary, AB T2N 4N1, Canada; turin.chowdhury{at}

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Commentary on: Boero IJ, Paravati AJ, Hou J, et al. The impact of surgeons on the likelihood of mastectomy in breast cancer. Ann Surg 2019;269(5):951-58. doi:10.1097/SLA.0000000000002698.

Implications for practice and research

  • The significant association between provider-level (individual physicians and treatment hospitals) characteristics and the likelihood of the type of surgery (mastectomy vs breast-conserving surgery) among patients with breast cancer provides insight on how elements of the healthcare system can influence a treatment choice.

  • Future research is required to clarify the complex interaction between patient-level and provider-level factors and how they influence the decision-making for choosing treatment modality.


Two of the major surgical treatment options available for invasive breast cancer include mastectomy and breast-conserving surgery (BCS). Recent studies have shown a better survival rate for BCS followed by radiation therapy compared with mastectomy, emphasising the importance of understanding the reasons behind choosing mastectomy …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.