Minority patients are less actively involved in surgeon and hospital selection for breast cancer surgery, according to a study published in JAMA Oncology.

Rachel A. Freedman, M.D., M.P.H., from the Dana-Farber Cancer Institute in Boston, and colleagues surveyed 500 women with stage 0 to III breast cancer diagnosed during 2010 through 2011 to examine racial/ethnic differences in surgeon and hospital selection.

The researchers found that referral by another physician was the most frequently reported reason for surgeon selection (78 percent), while hospitals were most frequently selected because they were part of a patient’s health plan (58 percent).

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More black and Spanish-speaking Hispanic women than white women reported selecting their surgeon based on physician referral (79 to 87 percent versus 76 percent; P = 0.007), after adjustment.

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Compared with white patients, black and Hispanic patients were less likely to report selecting their surgeon (adjusted rates, 18 and 22 percent, respectively, versus 32 percent; P = 0.02) and their hospital (adjusted rates, 7 and 15 percent, respectively, versus 23 percent; P = 0.003) based on reputation.

Selection of a surgeon based on reputation correlated with increased likelihood of rating the care from the surgeon as excellent (adjusted odds ratio, 2.21).

“Interventions to promote involvement in surgeon and hospital selection may have potential for addressing disparities related to lower-quality care from surgeons and hospitals,” the authors write.


  1. Freedman, Rachel A., et al. “Racial/Ethnic Differences in Patients’ Selection of Surgeons and Hospitals for Breast Cancer Surgery.” JAMA Oncology. doi:10.1001/jamaoncol.2015.20. [epub ahead of print]. March 19, 2015.