Breast cancer

28 June 2013

Less care for rural US breast cancer patients

Rural US breast cancer patients are less likely than those in cities to receive recommended radiation therapy after a lumpectomy, a new study finds.


Breast cancer patients in rural areas of the United States are less likely than those in cities to receive recommended radiation therapy after having a lumpectomy, a new study finds.

Lumpectomy is a breast-sparing surgery that removes only tumours and surrounding tissue.

"The lumpectomy findings are worrisome because lack of follow-up radiation therapy could lead to recurrence, another surgery, and another time period of concern for the woman and her family," Elizabeth Habermann, associate scientific director of surgical outcomes at the Mayo Clinic Center for the Science of Health Care Delivery, said in a Mayo news release.

The analysis of data from nearly 350 000 California breast cancer patients treated between 1996 and 2008 revealed other differences in diagnosis and treatment between rural and urban patients, the researchers said.

Corrective action

Rural women were less likely to have their oestrogen-receptor status tested and their tumour graded, which are two important parts of the diagnostic work-up for breast cancer. Rural women were also more likely to choose mastectomy (complete removal of the breast) rather than lumpectomy.

The findings were presented at the AcademyHealth annual research meeting, held June 23-25 in Baltimore.

"These study results are concerning," Habermann said. "All women should receive guideline-recommended cancer care, regardless of where they live."

She and her colleagues said further research is needed to determine the reasons for the differences between rural and urban breast cancer patients, so that action can be taken to correct them.

Despite the deviation from recommended treatment, no significant difference in death rates was noted between rural and urban breast cancer patients.

The data and conclusions of research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The US National Cancer Institute has more about breast cancer treatment.

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Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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