Saving the Breast From Cancer: Only for the Rich?
WebMD News Archive
May 11, 2000 (Washington) -- Poor, less-educated women with breast cancer
are more likely to lose a breast to the disease than are their more affluent
counterparts, a new study shows. Wealthy, college-educated women are more
likely to undergo a procedure called lumpectomy.
A lumpectomy is when only the tumor is removed, leaving the breast
essentially intact, and the patient then undergoes radiation or chemotherapy
treatments afterward. The cancer has to meet certain criteria (such as small
size) to be eligible for this treatment. Mastectomy is removal of all the
breast tissue and sometimes the muscle underlying the area.
To discover "what factors influence a woman's choice to undergo
lumpectomy or mastectomy," lead researcher Lisa F. Baron, MD, and
colleagues at The Medical University of South Carolina in Charleston surveyed
almost 680 breast cancer survivors who'd been treated at North Carolina and
South Carolina centers between 1995 and 1998. She presented the results of the
study at a medical conference here this week.
The women answered questions about their age, income, marital status, and
education level at the time of diagnosis, their family history, whether they'd
ever been pregnant, how their cancer was detected, and where they'd received
their treatment information. "We asked if they talked to their friends or
clergymen, who they confided in, and what treatment their physician had
recommended," says Baron.
Of the 406 women who responded, almost 350 had undergone mastectomy and 58
had undergone lumpectomy. Those patients were matched up for age at the time of
diagnosis, marital status, family breast cancer history, and prior
Of all the variables, says Baron, "what made a difference was patient
education and income." Compared to women who'd had a mastectomy, those
who'd undergone lumpectomy were wealthier, were more likely to be college
graduates, and tended to be married at the time of diagnosis.
According to Baron, there are a number of possible explanations.
Lower-income, less-educated women may not have easy access to transportation or
affordable child care, or have the job flexibility necessary to allow the six
weeks of daily, tiring chemotherapy treatments that go along with the
lumpectomy procedure. Mastectomy, on the other hand, is quicker and does not
require additional resources.