Conversely, only half of the patients who chose lumpectomy, and lived 40 miles or more away from the treatment center, received the recommended radiotherapy treatment compared to those who lived within 10 miles of a center. The study was reported in the current issue of the Journal of the National Cancer Institute.

"Mastectomy may be the best treatment choice for women who cannot complete radiotherapy following lumpectomy because of travel or other reasons," says Ann B. Nattinger, M.D., professor and chief of internal medicine at the Medical College and lead author of the study. "A woman should make her treatment choice very carefully because lumpectomy without radiotherapy has a 35 percent risk of local disease recurrence."

The study looked at records for 17,729 women aged 30 and over with early (Stage I or II) breast cancer from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Registry. Of the 7,384 patients who underwent breast-conserving surgery, only 75 percent completed the recommended radiotherapy, regardless of age.

In previous studies, Dr. Nattinger showed that treatment choices were also influenced by geographic location and population density such as living in urban or rural areas.

Dr. Nattinger, who practices at Froedtert Hospital in Milwaukee, says that women who live more than 15 miles from a treatment center may not perceive they have a choice in their treatment. This is an issue that should be addressed by health policy experts when considering accessibility to health care services.

Other members of the Medical College research team included Raymond Hoffman, Ph.D., associate professor of biostatistics; Ronald Kneussel, M.S., computer programmer; and Mary Ann Gilligan, M.D., M.P.H., assistant professor of general internal medicine.

[Contact: Toranj Marphetia]

15-Oct-2001