Surgical Management of Breast Cancer in a Small Peripheral New Zealand Hospital

Abstract

High rates of BCS are possible in peripheral hospitals. We postulate that intensive support and a visiting outpatient oncological service help empower patients to seek BCS if appropriate. A strong partnership between surgical, radiological and oncological services is also vital.

Why Taranaki women choose to have a mastectomy when suitable for breast conservation treatment

“…The overall BCT rate would have risen to 39% if radiotherapy facilities had been locally available, as 17 women would have changed their decision from mastectomy to BCT. This is still low, but more comparable with both national and international rates 4,8,9 . The distance to radiotherapy facilities (which is a surrogate for not only travel but time away from work, home and supporting family or friends) has been reported previously to be a potential factor in low BCT rates.…”

“…This is still low, but more comparable with both national and international rates. 4,8,9 The distance to radiotherapy facilities (which is a surrogate for not only travel but time away from work, home and supporting family or friends) has been reported previously to be a potential factor in low BCT rates. Meden et al 10 found an association between distance to radiotherapy facilities and BCT with a 14.3% rate in rural areas (45 miles from radiotherapy facilities) compared with 41.7% in urban areas, n = 66.…”

“…The Auckland Breast Cancer Study Group, based in the largest centre in New Zealand, has a BCT rate of 44.8% 8 . Wairau Hospital, providing for a small provincial centre in NZ without radiotherapy facilities, has a BCT rate of 58.6% 9 …”

“…Wairau Hospital, providing for a small provincial centre in NZ without radiotherapy facilities, has a BCT rate of 58.6%. 9 In the province of Taranaki, New Zealand, there are no radiotherapy facilities available. The women are seen by a visiting radiooncologist as an outpatient, but they must then travel to Palmerston North, approximately 3.5 h by road for their treatment.…”

Mastectomy for management of breast cancer in Ibadan, Nigeria

“…In the period under review however, only about one third of the patients with breast cancer received surgical treatment. This breast cancer surgery (BCS) rate was low compared to findings from a similar review in New Zealand where 58.6% of their patients over a 5 year period had BCS [7]. The reasons that possibly contributed to the low mastectomy rate in our patients include late presentation with inoperable local or metastatic tumours necessitating only palliative or terminal care, inability to pay out-of-pocket for treatment, and unwillingness to have mastectomy with consequent loss to follow up [9].…”