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Wednesday, October 17, 2012

Age, travel time affect Canadian breast cancer patients' mastectomy rates


A report released earlier this week showed that age and travel time, among others, largely affect mastectomy rates among breast cancer patients in Canada.

The report, jointly released by the Canadian Institute for Health Information and the Canadian Partnership Against Cancer, examined surgical care for women with invasive breast cancer and those with the non-invasive form of the disease, ductal carcinoma in situ (DCIS). Mastectomy and breast-conserving surgery (BCS, commonly known as a lumpectomy) are two types of surgery used to treat invasive cancer and DCIS. For women diagnosed with smaller tumors, evidence shows that BCS followed by radiation treatment provides a survival rate comparable to mastectomy, the report said.


After following the surgical treatment of about 22,000 women for one year starting from the date of their initial surgery, the study identified a U-shaped relationship between age and mastectomy rates. Rates were relatively high, 44 percent, for women aged 18 to 49 and fell to 35 percent for those aged 50 to 69. Rates rose again to 45 percent for women aged 70 and older, according to the report. Women who choose BCS as their surgical option typically undergo post-surgical radiation therapy, which was provided only at certain cancer centers and often requires daily trips.

The report showed an increase in mastectomy rates corresponding to travel time between a woman's home and the cancer center offering radiation treatment. Mastectomy rates exceeded 50 percent for women who must travel 1.5 hours or longer to reach a center offering radiation treatment, it said.

While the choice between mastectomy and BCS is heavily influenced by the extent of the disease upon diagnosis, factors such as perceptions of risk, body image and attitudes toward radiation therapy and breast reconstruction play a role in determining treatment choices, it said. "Armed with information like this, health system planners and clinicians are in an ideal situation to identify strengths and opportunities within existing practice, which can collectively help to optimize breast cancer care and the experience of women who receive surgery as part of their treatment," said Heather Bryant, vice president of Cancer Programs, Clinical and Population Health at the Canadian Partnership Against Cancer.

In 2012, roughly 22,700 women are likely to be diagnosed with invasive breast cancer, making it the most commonly diagnosed cancer among Canadian women.

Xinhua.net
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