Underutilization of breast-conserving therapy in a predominantly rural population: need for improved surgeon and public education

Clinical Breast Cancer
P HokansonK D Miller

Abstract

Though breast-conserving therapy (BCT) was first recommended as the preferred treatment for women with early-stage breast cancer in 1990, little is known about the factors influencing or limiting the use of BCT in rural women. We retrospectively surveyed all surviving patients (227) referred to the Roger Maris Cancer Center over a 2-year period. Disease characteristics were verified by the tumor registry and random chart review. Responses were obtained from 171 patients (75%), a median of 26 months from diagnosis. The majority of patients were from rural areas; only 32% resided in towns with a population greater than or equal to 15,000. Thirty-five percent of those patients meeting published criteria had BCT. Patients who underwent BCT were younger (mean age 56.8 vs. 62.5, P = 0.01), more likely to have benign axillary lymph nodes (82% vs. 64%, P = 0.008), and more likely to be employed away from the home (66% vs. 44%, P = 0.01) than patients who underwent mastectomy (MRM). Distance from the nearest radiation facility did not affect treatment decisions (mean: 59.5 miles BCT vs. 52.6 miles MRM). Most patients (83%) ranked their surgeon as the most important source of information about treatment options. Perceived surgical recomm...Continue Reading

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Citations

Oct 6, 2009·Journal of the American College of Surgeons·Grace L SmithThomas A Buchholz
Oct 7, 2008·The Breast : Official Journal of the European Society of Mastology·Robert L FootePaula J Schomberg
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Jan 18, 2006·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·M Geraedts

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