Rural women less likely to get radiation therapy after lumpectomy

Volume 2, Issue 3, 2013

Summary

Researchers have discovered several rural disparities in breast cancer diagnosis and treatment.

Photograph showing Elizabeth B. Habermann, Ph.D., associate scientific director of Surgical Outcomes in the Mayo Clinic Center for the Science of Health Care Delivery

Elizabeth B. Habermann, Ph.D.

Women from rural areas who have breast cancer are less likely than their urban counterparts to receive recommended radiation therapy after having a lumpectomy, a study by Mayo Clinic and others has found.

The difference is one of several rural disparities in breast cancer diagnosis and treatment that the researchers discovered.

"These study results are concerning," said Elizabeth B. Habermann, Ph.D., associate scientific director of Surgical Outcomes in the Mayo Clinic Center for the Science of Health Care Delivery. "All women should receive guideline-recommended cancer care, regardless of where they live."

Using the 1996-2008 California Cancer Registry, researchers at Mayo Clinic, the University of Minnesota and Georgetown University analyzed the care given to nearly 350,000 urban and rural women with all stages of breast cancer. Although there were no significant mortality differences between the two groups, researchers found that rural women were less likely to have their estrogen receptor status tested and their tumors graded — two important elements of the diagnostic work-up for breast cancer.

In addition, rural women were also more likely to choose mastectomy — complete removal of the breast — than lumpectomy, a breast-sparing surgery. Rural women who did choose lumpectomy were less likely to get the recommended radiation therapy after surgery, the study found.

"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," Dr. Habermann explained.

The findings were presented at the 2013 AcademyHealth Annual Research Meeting.

Watch a video of Dr. Habermann discussing this study.