Table 2.
Predictors of Timing of Surgeon Consultation Relative to Biopsy
| Predictor | No. of Patients (N = 89,689) | No. of Patients With Prebiopsy Consultation | Unadjusted |
Adjusted |
||||
|---|---|---|---|---|---|---|---|---|
| RR | 95% CI | P* | RR | 95% CI | P* | |||
| Age, years | ||||||||
| < 70 | 18,098 | 12,131 | 1 | 1 | ||||
| 70-79 | 52,091 | 35,371 | 1.01 | 1.00 to 1.02 | .031 | 1.01 | 1.00 to 1.03 | .012 |
| ≥ 80 | 19,500 | 13,792 | 1.05 | 1.04 to 1.07 | < .001 | 1.06 | 1.05 to 1.07 | < .001 |
| Race/ethnicity | ||||||||
| White | 82,754 | 56,479 | 1 | 1 | ||||
| Black | 4,886 | 3,472 | 1.04 | 1.02 to 1.06 | < .001 | 1.05 | 1.03 to 1.07 | < .001 |
| Other | 2,049 | 1,343 | 0.96 | 0.93 to 0.99 | .009 | 0.96 | 0.93 to 0.99 | .001 |
| Medicaid coverage | ||||||||
| Yes | 5,442 | 4,012 | 1.08 | 1.07 to 1.10 | < .001 | 1.07 | 1.05 to 1.09 | < .001 |
| No | 84,247 | 57,282 | 1 | 1 | ||||
| Charlson comorbidity score | ||||||||
| ≤ 1 | 81,872 | 55,660 | 1 | 1 | ||||
| 2 | 5,412 | 3,864 | 1.05 | 1.03 to 1.07 | < .001 | 1.04 | 1.03 to 1.06 | < .001 |
| ≥ 3 | 2,405 | 1,770 | 1.08 | 1.06 to 1.11 | < .001 | 1.07 | 1.04 to 1.010 | < .001 |
| Year of BCS | ||||||||
| 2003 | 20,073 | 14,841 | 1.16 | 1.15 to 1.17 | < .001 | 1.14 | 1.12 to 1.15 | < .001 |
| 2004 | 18,841 | 13,342 | 1.17 | 1.16 to 1.19 | < .001 | 1.18 | 1.16 to 1.19 | < .001 |
| 2005 | 18,127 | 12,280 | 1.13 | 1.12 to 1.14 | < .001 | 1.13 | 1.12 to 1.14 | < .001 |
| 2006 | 18,160 | 11,972 | 1.09 | 1.07 to 1.10 | < .001 | 1.09 | 1.07 to 1.10 | < .001 |
| 2007 | 14,488 | 8,859 | 1 | 1 | ||||
| County of residence | ||||||||
| Rural | 17,713 | 13,612 | 1.06 | 1.05 to 1.07 | < .001 | 1.06 | 1.05 to 1.08 | < .001 |
| Urban | 71,976 | 47,682 | 1 | 1 | ||||
| Distance to nearest radiologic facility performing needle biopsy, miles | ||||||||
| ≤ 0.6 | 22,403 | 15,037 | 1 | 1 | ||||
| 0.7-3.4 | 22,400 | 14,343 | 0.96 | 0.95 to 0.97 | < .001 | 0.97 | 0.96 to 0.98 | < .001 |
| 3.5-8.1 | 22,476 | 15,337 | 1.02 | 1.00 to 1.03 | .011 | 1.03 | 1.02 to 1.04 | < .001 |
| ≥ 8.2 | 22,410 | 16,577 | 1.10 | 1.09 to 1.12 | < .001 | 1.07 | 1.05 to 1.08 | < .001 |
| Mammography before surgical consultation or needle biopsy | ||||||||
| Yes | 77,791 | 52,404 | 1 | 1 | ||||
| No | 11,898 | 8,890 | 1.11 | 1.10 to 1.12 | < .001 | 1.11 | 1.10 to 1.12 | < .001 |
| Visit with PCP before surgical consultation or needle biopsy | ||||||||
| Yes | 58,475 | 40,640 | 1.05 | 1.04 to 1.06 | < .001 | 1.05 | 1.04 to 1.06 | < .001 |
| No | 31,214 | 20,654 | 1 | 1 | ||||
Abbreviations: BCS, breast-conserving surgery; PCP, primary care provider; RR, relative risk.
*
Statistical significance evaluated at the P = .05 level in both unadjusted and adjusted analyses. A RR > 1 indicates the factor was associated with a higher likelihood that the patient was evaluated by her surgeon before biopsy. A total of 23 patients were excluded as a result of unknown covariates. Model fit was acceptable (Hosmer-Lemeshow, P = .33).