According to a study conducted in Florida, women with localized breast cancer are more likely to receive breast conserving surgery and radiation therapy (BCSR), rather than mastectomy, if they live closer to a radiation therapy facility. Women were also more likely to receive BCSR if they were married, younger, of white non-Hispanic race, and insured (private health insurance or Medicare). These results were published in the journal Cancer.
In the treatment of localized breast cancer (cancer that is confined to the breast), breast-conserving surgery (removal of the cancer and some of the surrounding tissue) plus radiation therapy has produced similar outcomes to mastectomy (removal of the entire breast). A variety of factors, however, may limit the ability of a woman to choose freely between these two options.
To test the hypothesis that greater distance from a radiation therapy facility would decrease the probability of treatment with BCSR, researchers evaluated information from a statewide registry in Florida. Between July 1997, and December 2000, a total of 18,903 women with localized breast cancer were treated with either BCSR (11,354 women) or mastectomy (7549 women).
Factors that influenced the probability of treatment with BCSR included distance from a radiation facility, age, race, insurance status, and marital status:
- Women who lived farther from a radiation therapy facility were less likely to be treated with BCSR: The probability of BCSR declined by 3% for each five-mile increase in distance.
- Younger women were more likely to be treated with BCSR: The probability of BCSR declined by 6% for each five-year increase in age.
- White non-Hispanic women were more likely to be treated with BCSR: Compared to white non-Hispanic women, Hispanic women were 38% less likely to receive BCSR.
- Women with health insurance were more likely to receive BCSR: Compared to uninsured women, women with private health insurance were 49% more likely to receive BCSR, and women with Medicare were 37% more likely to receive BCSR.
- Married women were more likely to receive BCSR: Compared to single women, married women were 23% more likely to receive BCSR.
The researchers conclude that “Future efforts should target the uninsured, Hispanics, the elderly, and the unmarried women to reduce disparities in the administration of BCSR for local breast carcinoma.”
Reference: Voti L, Richardson LC, Reis IM et al. Treatment of Local Breast Carcinoma in Florida: The Role of the Distance to Radiation Therapy Facilities. Cancer. Early online publication November 28, 2005.
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