Researchers Identify Barriers to Early-Stage Breast Cancer Treatment
An evaluation of data in the National Cancer Database found that economic status and travel distance to treatment facilities continue to prevent some women from getting a lumpectomy. Study author Megan Ann Lautner, MD, of The University of Texas San Antonio, announced findings at the American Society of Clinical Oncology 2014 Breast Cancer Symposium on September 4.
Lumpectomy, also called breast-conserving surgery, followed by six weeks of radiation has been a widely accepted treatment for early-stage breast cancer since 1990. Breast-conserving surgery rates have increased during the last two decades, and differences based on age, place of residence and type of cancer program have improved. But a number of people with early-stage disease who can get lumpectomy still choose mastectomy.
Researchers used the National Cancer Database, a registry that captures about 70 percent of newly diagnosed cases of cancer in the country, to evaluate 727,927 people diagnosed with early-stage breast cancer between 1998 and 2011 who chose either lumpectomy or mastectomy to find out what factors may have influenced their choice of surgery.
Researchers found that lumpectomy rates increased from 54 percent in 1998 to 59 percent in 2006, and then leveled off for the rest of the study period. After accounting for differences by type of person and traits of the cancer, lumpectomy was given more often in:
- people diagnosed with breast cancer ages 52-61, compared to younger people
- people with higher education level and income
- people with private insurance compared to the uninsured
- academic cancer programs compared to community cancer programs
- facilities in the Northeast compared to facilities in the South
- people who lived within 17 miles of a treatment facility compared to those who lived farther away
Although lumpectomy rates improved between 1998 and 2011 across all age groups, in community cancer programs and at facilities in the South, differences by insurance status, income level and travel greater than 17 miles to a treatment center continue to prevent women from choosing lumpectomy.
What This Means for You
Be sure to talk to your doctor about your treatment options and ways to cover the cost. If you are uninsured or underinsured, you are able to buy private insurance through your state Health Insurance Marketplace/Exchange during an open enrollment period; the next one runs from November 15, 2014, to February 15, 2015. Use this Cancer Insurance Checklist as a first step to consider what you need.
Trained navigators can help you find the best plan for you and your family and help you determine if you are eligible for financial assistance. For more information, visit our financial concerns Web content or download our Guide to Understanding Financial Concerns. The guide also gives practical tips to help you handle travel costs and living expenses that might be of concern when you are making a surgery decision.