The study supports the conventional wisdom that transportation and geography are major factors in determining whether women with early stage breast cancer choose a mastectomy or breast-conserving lumpectomy with radiation. Thus, rural women are more likely to opt for a mastectomy, which doesn’t require radiation treatments, than for a lumpectomy. The farther away a woman lives from a radiation therapy facility, the less likely she is to choose the lumpectomy with radiation, which usually involves going to a hospital or doctor’s office five days a week for six weeks, says the study which appears in the January 2006 issue of medical journal Cancer.
Generally, women with early stage disease are given the choice between the two options, which are considered equally effective. The study looked at data from Florida’s cancer registry on 18,903 local breast carcinomas. The odds of receiving the lumpectomy plus radiation fell 3 percent for every five-mile increase in distance to the radiation facility.
The study also found that Hispanic women were 38 percent less likely to receive the lumpectomy and radiation than white patients, while married women were 23 percent more likely to receive lumpectomies and radiation. Some experts say that distance issues can be overcome by having radiation facilities offer transportation, which sounds like an obvious and practical solution.
I wonder if the study reflects the degree of fear women feel upon learning they have breast cancer. Some women opt to have their breasts removed because they are so afraid of the cancer coming back and killing them, despite the research that shows a lumpectomy plus radiation is equally effective. And we’ve all known or heard about women who have opted to have their breasts removed before they get breast cancer, or choose to have their second, healthy breast removed after they are diagnosed, because they are high risk.
It’s every woman’s right to choose her own treatment. But it seems like a good idea to remove artificial barriers such as transportation problems, which may be standing in the way of women getting the treatment they really want.