Geographic distance has long been a barrier discouraging some regional Queensland women from seeking reconstructive surgery after a mastectomy.
The joint Cancer Council and Mater Medical Centre study, published in the ANZ Journal of Surgery, is the first to report a significant reduction in geographic distance as a barrier to breast reconstructions.
While women from urban areas of Queensland were still significantly more likely to undergo breast reconstructions than those from remote areas, the difference has lessened over time.
Cancer Council Queensland CEO Professor Jeff Dunn AO said of those Queensland women who had a mastectomy after breast cancer, the proportion who had a subsequent breast reconstruction had increased over time.
“A range of factors are helping to reduce the geographical disparity – post-mastectomy breast reconstruction is strongly influenced by demographics, residential location and tumour size,” Prof Dunn said.
“An increase in the number of breast cancer surgeons with training and expertise in both oncological and reconstructive surgery may also be improving access for regional patients.
“Potentially, a high proportion of eligible women may not be offered breast reconstructions, or women may choose not to take up the surgery.
“Evidence shows the patient’s reluctance to have further surgery, a lack of information about the non-cosmetic benefits of reconstruction, and the clinician’s preferences may also influence a woman’s decision to have reconstructive surgery.”
Australian clinical guidelines recommend all women undergoing a mastectomy discuss the potential benefits of breast reconstruction on body image and psychosocial outcomes, to enable informed decision making.
“This trend provides great encouragement that geographic barriers to recommended treatment can be addressed,” Prof Dunn said.
“Better understanding of the reasons for the low uptake of reconstructive surgery, in particular those relating to health systems and appropriate provision of information, should continue as a priority for Queensland.”
The study examined more than 4000 cases of breast cancer in Queensland over a 16 year period (1997 to 2012).
Breast cancer is the most common cancer diagnosed in Queensland women – around 3300 new cases are diagnosed each year, and about 560 women die from the disease.
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