Quality of breast surgery care at a comprehensive cancer center and its rural affiliate hospital

Abstract

Background: Cancer centers are increasingly affiliating with rural hospitals to perform surgery. Perioperative and oncologic outcomes for cancer center surgeons operating at rural hospitals are understudied.

Methods: For patients with non-metastatic breast cancer from a rural catchment area who had oncologic surgery at an NCI-designated comprehensive cancer center (CC) or its rural affiliate (RA) from 2017 to 2022, we compared perioperative outcomes (composite of surgical site infection, seroma requiring drainage, and reoperation for margins) and receipt of guideline-concordant care (if patient received all applicable treatments) using descriptive statistics and chi-squared tests.

Results: Among 168 patients, 99 had surgery at RA, 60 CC. RA patients were older, higher stage, and more often had lumpectomy. There were no differences in perioperative outcomes (CC 10%, RA 14%, p ​= ​0.445) or guideline concordant care (RA 76%, CC 78%, p ​= ​0.846).

Conclusions: Cancer center surgeons operating at a rural affiliate had comparable perioperative outcomes and guideline-concordant care.

Keywords: Breast cancer; Perioperative outcomes; Quality of care; Rural hospitals; Surgery.