Are mastectomy rates really increasing in the United States?
After the National Institutes of Health Consensus Statement in 1990, breast-conserving surgery (BCS) became more common while mastectomy rates decreased. However, several recently published single-institution studies have reported an increase in mastectomy rates in the past decade. We conducted a po...
Uloženo v:
| Vydáno v: | Journal of clinical oncology Ročník 28; číslo 21; s. 3437 |
|---|---|
| Hlavní autoři: | , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
20.07.2010
|
| Témata: | |
| ISSN: | 1527-7755, 1527-7755 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | After the National Institutes of Health Consensus Statement in 1990, breast-conserving surgery (BCS) became more common while mastectomy rates decreased. However, several recently published single-institution studies have reported an increase in mastectomy rates in the past decade. We conducted a population-based study to evaluate national trends in the surgical treatment of breast cancer from 2000 through 2006.
Using the Surveillance, Epidemiology, and End Results database, we conducted a retrospective cohort analysis of women undergoing surgical treatment for breast cancer. We evaluated variation in mastectomy rates by demographic and tumor factors and calculated differences in mastectomy rates across time. We utilized logistic regression to identify time trends and patient and tumor factors associated with mastectomy, testing for significance using two-sided methods.
We identified 233,754 patients diagnosed with ductal carcinoma in situ or stage I to III unilateral breast cancer from 2000 to 2006. The proportion of women treated with mastectomy decreased from 40.8% in 2000 to 37.0% in 2006 (P < .001). These patterns were maintained across patient and tumor factors. Although the unilateral mastectomy rate decreased during the study period, the contralateral prophylactic mastectomy rate increased. Women were less likely to receive mastectomy over time (odds ratio, 1.18 for 2000 v 2006; 95% CI, 1.14 to 1.23; P < .0001), after adjusting for patient and tumor factors.
In contrast to single-institution studies, our population-based analysis found a decrease in unilateral mastectomy rates from 2000 to 2006 in the United States. Variations in referral patterns and patient selection are potential explanations for these differences between single institutions and national trends. |
|---|---|
| AbstractList | After the National Institutes of Health Consensus Statement in 1990, breast-conserving surgery (BCS) became more common while mastectomy rates decreased. However, several recently published single-institution studies have reported an increase in mastectomy rates in the past decade. We conducted a population-based study to evaluate national trends in the surgical treatment of breast cancer from 2000 through 2006.
Using the Surveillance, Epidemiology, and End Results database, we conducted a retrospective cohort analysis of women undergoing surgical treatment for breast cancer. We evaluated variation in mastectomy rates by demographic and tumor factors and calculated differences in mastectomy rates across time. We utilized logistic regression to identify time trends and patient and tumor factors associated with mastectomy, testing for significance using two-sided methods.
We identified 233,754 patients diagnosed with ductal carcinoma in situ or stage I to III unilateral breast cancer from 2000 to 2006. The proportion of women treated with mastectomy decreased from 40.8% in 2000 to 37.0% in 2006 (P < .001). These patterns were maintained across patient and tumor factors. Although the unilateral mastectomy rate decreased during the study period, the contralateral prophylactic mastectomy rate increased. Women were less likely to receive mastectomy over time (odds ratio, 1.18 for 2000 v 2006; 95% CI, 1.14 to 1.23; P < .0001), after adjusting for patient and tumor factors.
In contrast to single-institution studies, our population-based analysis found a decrease in unilateral mastectomy rates from 2000 to 2006 in the United States. Variations in referral patterns and patient selection are potential explanations for these differences between single institutions and national trends. After the National Institutes of Health Consensus Statement in 1990, breast-conserving surgery (BCS) became more common while mastectomy rates decreased. However, several recently published single-institution studies have reported an increase in mastectomy rates in the past decade. We conducted a population-based study to evaluate national trends in the surgical treatment of breast cancer from 2000 through 2006.PURPOSEAfter the National Institutes of Health Consensus Statement in 1990, breast-conserving surgery (BCS) became more common while mastectomy rates decreased. However, several recently published single-institution studies have reported an increase in mastectomy rates in the past decade. We conducted a population-based study to evaluate national trends in the surgical treatment of breast cancer from 2000 through 2006.Using the Surveillance, Epidemiology, and End Results database, we conducted a retrospective cohort analysis of women undergoing surgical treatment for breast cancer. We evaluated variation in mastectomy rates by demographic and tumor factors and calculated differences in mastectomy rates across time. We utilized logistic regression to identify time trends and patient and tumor factors associated with mastectomy, testing for significance using two-sided methods.PATIENTS AND METHODSUsing the Surveillance, Epidemiology, and End Results database, we conducted a retrospective cohort analysis of women undergoing surgical treatment for breast cancer. We evaluated variation in mastectomy rates by demographic and tumor factors and calculated differences in mastectomy rates across time. We utilized logistic regression to identify time trends and patient and tumor factors associated with mastectomy, testing for significance using two-sided methods.We identified 233,754 patients diagnosed with ductal carcinoma in situ or stage I to III unilateral breast cancer from 2000 to 2006. The proportion of women treated with mastectomy decreased from 40.8% in 2000 to 37.0% in 2006 (P < .001). These patterns were maintained across patient and tumor factors. Although the unilateral mastectomy rate decreased during the study period, the contralateral prophylactic mastectomy rate increased. Women were less likely to receive mastectomy over time (odds ratio, 1.18 for 2000 v 2006; 95% CI, 1.14 to 1.23; P < .0001), after adjusting for patient and tumor factors.RESULTSWe identified 233,754 patients diagnosed with ductal carcinoma in situ or stage I to III unilateral breast cancer from 2000 to 2006. The proportion of women treated with mastectomy decreased from 40.8% in 2000 to 37.0% in 2006 (P < .001). These patterns were maintained across patient and tumor factors. Although the unilateral mastectomy rate decreased during the study period, the contralateral prophylactic mastectomy rate increased. Women were less likely to receive mastectomy over time (odds ratio, 1.18 for 2000 v 2006; 95% CI, 1.14 to 1.23; P < .0001), after adjusting for patient and tumor factors.In contrast to single-institution studies, our population-based analysis found a decrease in unilateral mastectomy rates from 2000 to 2006 in the United States. Variations in referral patterns and patient selection are potential explanations for these differences between single institutions and national trends.CONCLUSIONIn contrast to single-institution studies, our population-based analysis found a decrease in unilateral mastectomy rates from 2000 to 2006 in the United States. Variations in referral patterns and patient selection are potential explanations for these differences between single institutions and national trends. |
| Author | Virnig, Beth A Al-Refaie, Waddah B Abbott, Andrea Parsons, Helen M Habermann, Elizabeth B Tuttle, Todd M |
| Author_xml | – sequence: 1 givenname: Elizabeth B surname: Habermann fullname: Habermann, Elizabeth B email: ebh@umn.edu organization: University of Minnesota andVeterans Affairs Medical Center, Minneapolis, MN, USA. ebh@umn.edu – sequence: 2 givenname: Andrea surname: Abbott fullname: Abbott, Andrea – sequence: 3 givenname: Helen M surname: Parsons fullname: Parsons, Helen M – sequence: 4 givenname: Beth A surname: Virnig fullname: Virnig, Beth A – sequence: 5 givenname: Waddah B surname: Al-Refaie fullname: Al-Refaie, Waddah B – sequence: 6 givenname: Todd M surname: Tuttle fullname: Tuttle, Todd M |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20548000$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNj0tLxDAURoOMOA_du5LsXLXeJuncFAQZik8GZqGzLml6q5U-xiZd9N9bcQRX31kcDnxLNmu7lhi7jCCMBMDNS7oLp01CgeEaUZ2wRRQLDBDjePaP52zp3CdApLSMz9hcQKw0ACzY7aYn3hjnyfquGXlvPDnek6nrkVetnchV7fuE3H8Q37eVp4K_-h_t7pydlqZ2dHHcFds_3L-lT8F29_icbraBVWLtg0RGOaJAmUuD0hZGWxslQqHOsdClSXRCpSRRSLISARTY0kgBlJdgEkVixa5_u4e--xrI-aypnKW6Ni11g8tQyqmhMZ7Mq6M55A0V2aGvGtOP2d9h8Q2CzlkD |
| CitedBy_id | crossref_primary_10_1016_j_clbc_2014_07_009 crossref_primary_10_1016_j_amjsurg_2012_05_007 crossref_primary_10_1186_1748_717X_6_26 crossref_primary_10_1007_s10549_017_4371_9 crossref_primary_10_1016_j_breast_2013_09_011 crossref_primary_10_1177_000313481708300726 crossref_primary_10_1016_j_breastdis_2011_06_048 crossref_primary_10_1186_s12913_015_0680_z crossref_primary_10_1245_s10434_019_07345_4 crossref_primary_10_1016_j_suc_2018_04_003 crossref_primary_10_1002_cncr_26417 crossref_primary_10_29289_2594539420250004 crossref_primary_10_1097_PRS_0000000000005690 crossref_primary_10_1177_000313481508100225 crossref_primary_10_1016_j_canep_2016_02_011 crossref_primary_10_1245_s10434_014_3924_y crossref_primary_10_1245_s10434_014_4233_1 crossref_primary_10_1016_j_jgo_2017_10_003 crossref_primary_10_1016_j_semradonc_2015_09_007 crossref_primary_10_1016_j_suc_2012_12_006 crossref_primary_10_3390_jcm14155204 crossref_primary_10_1016_j_jhsa_2011_06_020 crossref_primary_10_3109_2000656X_2014_899240 crossref_primary_10_1016_j_juro_2011_09_150 crossref_primary_10_1055_a_2253_8442 crossref_primary_10_1016_S1470_2045_12_70246_2 crossref_primary_10_1016_j_radonc_2019_05_022 crossref_primary_10_1097_PRS_0000000000006438 crossref_primary_10_1177_1178223417726777 crossref_primary_10_1245_s10434_014_4248_7 crossref_primary_10_2217_ahe_12_69 crossref_primary_10_1097_PRS_0000000000004498 crossref_primary_10_1245_s10434_015_4591_3 crossref_primary_10_1016_j_jss_2017_11_058 crossref_primary_10_1097_PRS_0000000000004019 crossref_primary_10_1016_j_breast_2013_09_010 crossref_primary_10_1016_j_jss_2018_09_063 crossref_primary_10_1590_S1516_31802012000600002 crossref_primary_10_1186_1745_6215_14_199 crossref_primary_10_5812_aapm_39476 crossref_primary_10_1111_1744_1633_12075 crossref_primary_10_1245_s10434_019_07265_3 crossref_primary_10_1038_s41598_018_29946_x crossref_primary_10_3109_2000656X_2014_884973 crossref_primary_10_1016_j_breastdis_2012_04_021 crossref_primary_10_1245_s10434_015_4709_7 crossref_primary_10_1016_j_breastdis_2014_07_028 crossref_primary_10_1007_s10549_018_4754_6 crossref_primary_10_1245_s10434_022_12190_z crossref_primary_10_1111_tbj_13295 crossref_primary_10_1007_s00268_012_1469_4 crossref_primary_10_1136_bmjopen_2017_020858 crossref_primary_10_3390_jcm13133665 crossref_primary_10_1097_SAP_0000000000000963 crossref_primary_10_1002_cncr_25821 crossref_primary_10_1016_j_amjsurg_2013_07_001 crossref_primary_10_1177_000313481708300317 crossref_primary_10_1016_j_whi_2014_03_001 crossref_primary_10_4061_2011_873987 crossref_primary_10_1111_j_1524_4741_2012_01245_x crossref_primary_10_1111_nuf_12108 crossref_primary_10_1245_s10434_011_2080_x crossref_primary_10_1200_JCO_2013_52_2284 crossref_primary_10_1097_NCC_0000000000000981 crossref_primary_10_1007_s11912_024_01553_2 crossref_primary_10_1155_2018_1426369 crossref_primary_10_1097_GOX_0000000000000819 crossref_primary_10_1245_s10434_012_2732_5 crossref_primary_10_1002_cncr_27838 crossref_primary_10_1007_s00520_014_2479_6 crossref_primary_10_1245_s10434_013_2982_x crossref_primary_10_1111_tbj_12076 crossref_primary_10_1634_theoncologist_2014_0041 crossref_primary_10_1016_j_amjsurg_2012_08_012 crossref_primary_10_1097_PRS_0000000000006011 crossref_primary_10_1016_j_amjsurg_2021_04_024 crossref_primary_10_1097_PRS_0000000000012068 crossref_primary_10_3389_fpubh_2023_1100421 crossref_primary_10_1002_jum_15881 crossref_primary_10_1177_1178223419864896 crossref_primary_10_1016_j_breastdis_2013_01_028 crossref_primary_10_1097_SAP_0000000000001965 crossref_primary_10_1245_s10434_015_4770_2 crossref_primary_10_1515_pjs_2016_0062 crossref_primary_10_3390_diagnostics12010184 crossref_primary_10_1016_j_clbc_2018_06_002 crossref_primary_10_1177_000313481207801139 crossref_primary_10_2217_fon_12_186 crossref_primary_10_1245_s10434_013_3097_0 crossref_primary_10_1148_rg_343135059 crossref_primary_10_1245_s10434_014_3521_0 crossref_primary_10_1007_s11604_012_0126_z crossref_primary_10_1016_j_bjps_2024_09_053 crossref_primary_10_1016_j_breastdis_2014_01_038 crossref_primary_10_1111_tbj_13037 crossref_primary_10_1177_00405175241303532 crossref_primary_10_1245_s10434_021_10495_z crossref_primary_10_1188_13_CJON_68_72 crossref_primary_10_1055_a_2685_3946 crossref_primary_10_1007_s13193_015_0450_8 crossref_primary_10_1097_PRS_0000000000004727 crossref_primary_10_1097_SLA_0000000000001972 crossref_primary_10_1371_journal_pone_0084535 crossref_primary_10_1002_jso_23340 crossref_primary_10_1097_SLA_0000000000005386 crossref_primary_10_1016_j_bjps_2012_05_001 crossref_primary_10_3389_fonc_2022_1032063 crossref_primary_10_1016_j_surge_2014_02_005 crossref_primary_10_1097_NCC_0000000000000564 crossref_primary_10_1002_jso_27940 crossref_primary_10_1017_S146039692000045X crossref_primary_10_1016_j_ijrobp_2011_10_075 crossref_primary_10_1097_SAP_0000000000002802 crossref_primary_10_1590_S0100_69912013000300003 crossref_primary_10_1111_papr_12933 crossref_primary_10_5812_ijcm_114082 crossref_primary_10_1007_s10689_011_9484_4 crossref_primary_10_1016_j_jbiomech_2021_110348 crossref_primary_10_1245_s10434_012_2693_8 crossref_primary_10_1016_j_bjps_2023_06_016 crossref_primary_10_1177_000313481508100133 crossref_primary_10_3390_medicina56100505 crossref_primary_10_1245_s10434_015_4378_6 crossref_primary_10_1097_AAP_0000000000000479 crossref_primary_10_1007_s10549_016_3707_1 crossref_primary_10_1016_j_ctro_2025_101015 crossref_primary_10_1097_PRS_0000000000005904 crossref_primary_10_1016_j_breastdis_2013_10_009 crossref_primary_10_1111_tbj_12449 crossref_primary_10_1002_jso_21699 crossref_primary_10_1016_j_ejca_2012_03_008 crossref_primary_10_1245_s10434_013_3148_6 crossref_primary_10_1177_000313481608200316 crossref_primary_10_1245_s10434_014_3945_6 crossref_primary_10_7759_cureus_15732 crossref_primary_10_1016_j_jclinane_2015_04_003 crossref_primary_10_1016_j_breastdis_2012_03_021 crossref_primary_10_5812_ijcm_88551 crossref_primary_10_1245_s10434_012_2530_0 crossref_primary_10_1245_s10434_014_3923_z crossref_primary_10_1667_RR14475_1 crossref_primary_10_1089_jwh_2018_7350 crossref_primary_10_1309_AJCPRSOA2G8RLEXY crossref_primary_10_1016_j_clbc_2022_12_021 crossref_primary_10_1007_s10897_017_0099_2 crossref_primary_10_1016_j_ejso_2011_12_014 crossref_primary_10_1016_j_breastdis_2010_10_016 crossref_primary_10_1016_S1470_2045_16_30673_8 crossref_primary_10_1245_s10434_025_18030_0 crossref_primary_10_1002_jso_24572 crossref_primary_10_1016_j_pec_2010_08_009 crossref_primary_10_1007_s00268_012_1530_3 crossref_primary_10_1186_1471_2407_14_658 crossref_primary_10_3389_fonc_2020_518568 crossref_primary_10_1148_rg_343135188 crossref_primary_10_1111_tbj_13007 crossref_primary_10_1177_000313481608200609 crossref_primary_10_1007_s10549_014_3024_5 crossref_primary_10_1016_j_bjps_2015_04_004 crossref_primary_10_1016_j_breast_2011_02_020 crossref_primary_10_1245_s10434_012_2678_7 |
| ContentType | Journal Article |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1200/JCO.2009.27.6774 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine Pharmacy, Therapeutics, & Pharmacology |
| EISSN | 1527-7755 |
| ExternalDocumentID | 20548000 |
| Genre | Journal Article |
| GeographicLocations | United States |
| GeographicLocations_xml | – name: United States |
| GroupedDBID | --- .55 0R~ 18M 2WC 34G 39C 3O- 4.4 53G 5GY 5RE 8F7 AARDX AAWTL AAYEP AAYOK ABJNI ABOCM ACGFO ACGFS ACGUR ADBBV AEGXH AENEX AFFNX AI. AIAGR ALMA_UNASSIGNED_HOLDINGS BAWUL C45 CGR CS3 CUY CVF DIK EBS ECM EIF EJD F5P F9R FBNNL FD8 GX1 H13 HZ~ IH2 KQ8 L7B LSO MJL N4W N9A NPM O9- OK1 OVD OWW P2P QTD R1G RHI RLZ RUC SJN TEORI TR2 TWZ UDS VH1 VVN WH7 X7M YCJ YFH YQY 7X8 ABBLC |
| ID | FETCH-LOGICAL-c426t-931b77273b3a73cda8cc192478b7d8fa989ef3e2d3ec370040cfa320ebf0a94e2 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 186 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000280003700007&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1527-7755 |
| IngestDate | Mon Jul 21 10:40:21 EDT 2025 Thu Apr 03 07:10:24 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 21 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c426t-931b77273b3a73cda8cc192478b7d8fa989ef3e2d3ec370040cfa320ebf0a94e2 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| PMID | 20548000 |
| PQID | 733989875 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_733989875 pubmed_primary_20548000 |
| PublicationCentury | 2000 |
| PublicationDate | 2010-07-20 |
| PublicationDateYYYYMMDD | 2010-07-20 |
| PublicationDate_xml | – month: 07 year: 2010 text: 2010-07-20 day: 20 |
| PublicationDecade | 2010 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Journal of clinical oncology |
| PublicationTitleAlternate | J Clin Oncol |
| PublicationYear | 2010 |
| SSID | ssj0014835 |
| Score | 2.4435833 |
| Snippet | After the National Institutes of Health Consensus Statement in 1990, breast-conserving surgery (BCS) became more common while mastectomy rates decreased.... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 3437 |
| SubjectTerms | Adolescent Adult Aged Breast Neoplasms - surgery Female Humans Mastectomy - statistics & numerical data Mastectomy - trends Middle Aged SEER Program Time Factors United States - epidemiology |
| Title | Are mastectomy rates really increasing in the United States? |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/20548000 https://www.proquest.com/docview/733989875 |
| Volume | 28 |
| WOSCitedRecordID | wos000280003700007&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1NS8NAEF3Uinjxo37VL_YgPTU2zW6yKQilFIuIrTlU6a3sbjZQaJPaVCH_3pkktSfx4CXkkpDsTmbf7Ju8R8idZ1xIepxZUP1IpBm1pQzzLOm1tFFQEYX5hv77ixgO_fG4HZS9OWnZVrnOiXmiDhONe-RNwRhaHQq3s_iw0DQKydXSQWObVBggGezoEuMNicD93F8TjVsBRLpuyVJCXDSfe6-FVqUj7j2B3X6_4ct8nekf_vMJj8hBCTBpt4iIY7Jl4irZG5QUepXUg0KsOmvQ0ebfq7RB6zTYyFhnJ-ShuzR0LlNkGZJ5RlFTIqWAMWezjE5jRJu4zwCnFEAkLcArLcBr55S89R9HvSer9FqwNKzRK6vNWkogllFMCqZD6WuNtZnwlQj9SMKbmYgZJ2RGM5TEt3UkmWMbFdmyzY1zRnbiJDYXhIa-sSVnkYE44I5iivOQt7hwXMXhhrxG6Hr8JhDLSFDI2CSf6eRnBGvkvJiDyaLQ3Jg4NgrT2fbl3xdfkf2C4heQAq5JJYLv2NyQXf21mqbL2zxG4DgMBt-VuMUc |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Are+mastectomy+rates+really+increasing+in+the+United+States%3F&rft.jtitle=Journal+of+clinical+oncology&rft.au=Habermann%2C+Elizabeth+B&rft.au=Abbott%2C+Andrea&rft.au=Parsons%2C+Helen+M&rft.au=Virnig%2C+Beth+A&rft.date=2010-07-20&rft.eissn=1527-7755&rft.volume=28&rft.issue=21&rft.spage=3437&rft_id=info:doi/10.1200%2FJCO.2009.27.6774&rft_id=info%3Apmid%2F20548000&rft_id=info%3Apmid%2F20548000&rft.externalDocID=20548000 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1527-7755&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1527-7755&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1527-7755&client=summon |