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Journal Article

Temporal trends in breast cancer surgery in Ontario: can one randomized trial make a difference?

N. A. Iscoe, C. D. Naylor, J. I. Williams, G. DeBoer, M. W. Morgan, G. Fehringer and E. Holowaty
CMAJ April 01, 1994 150 (7) 1109-1115;
N. A. Iscoe
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C. D. Naylor
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J. I. Williams
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G. DeBoer
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M. W. Morgan
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G. Fehringer
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E. Holowaty
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Abstract

OBJECTIVE: To assess the effect of a single randomized clinical trial, the National Surgical Adjuvant Breast Project (NSABP) B-06, on the surgical management of breast cancer in women. DESIGN: Retrospective cohort study. SETTING: All hospitals in Ontario. PATIENTS: A consecutive sample of 37,447 women with breast cancer newly diagnosed from Jan. 1, 1980, to Dec. 31, 1989, linked to a surgical procedure record in the Ontario Cancer Registry. MAIN OUTCOME MEASURE: The most invasive surgical procedure used within 90 days of diagnosis. RESULTS: Unilateral breast-ablative surgery (BAS) was performed in 57.3% of the women and breast-conserving surgery (BCS) in 31.6%. The annual rate of BAS declined from 77.5% in 1980 to 44.2% in 1989 and the rate of BCS rose from 12.5% in 1980 to 43.5% in 1989. The decline was linear from 1980 to 1984 and then accelerated significantly in 1985 (p < 0.0001), after the results of the NSABP B-06 trial were published. CONCLUSION: One randomized clinical trial can have an immediate and profound effect on medical practice.

  • Copyright © 1994 by Canadian Medical Association
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CMAJ
Vol. 150, Issue 7
1 Apr 1994
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Temporal trends in breast cancer surgery in Ontario: can one randomized trial make a difference?
N. A. Iscoe, C. D. Naylor, J. I. Williams, G. DeBoer, M. W. Morgan, G. Fehringer, E. Holowaty
CMAJ Apr 1994, 150 (7) 1109-1115;

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Temporal trends in breast cancer surgery in Ontario: can one randomized trial make a difference?
N. A. Iscoe, C. D. Naylor, J. I. Williams, G. DeBoer, M. W. Morgan, G. Fehringer, E. Holowaty
CMAJ Apr 1994, 150 (7) 1109-1115;
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