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Waiting times for radiotherapy help to convince some breast cancer patients to have a mastectomy rather than a smaller operation followed by radiation, new research has found.
The Taranaki Base Hospital study, presented to a surgeons' conference in Christchurch yesterday, asked women who were suitable for breast-conserving treatment - a partial mastectomy plus radiation - why they chose that or a full mastectomy.
Surgical registrar Dr Susan Gollop found that 17 of the 73 women suitable for breast-conserving treatment but who had a full mastectomy would have opted for the partial one if they could have received radiotherapy locally.
Taranaki patients needing radiotherapy travel to Palmerston North Hospital, although specialists come to their province for outpatient clinics.
"Travel distance, time away from family, wait for treatment, exposure to radiation and fear of side-effects were other important considerations to this group," Dr Gollop said.
Waiting times have been a recurring problem for radiotherapy in New Zealand this decade, leading to many priority C patients waiting longer than the national recommendation of a maximum of four weeks from their first visit to a radiation oncologist. The delays have led to some patients being sent to Australia by their district health board for the treatment.
Dr Gollop said 31 per cent of breast cancer patients in her study had breast-conserving treatment, compared with international rates of around half. Australian and American research had also found lower rates of breast conservation in regions without radiotherapy facilities.
She found that fear of recurrence and having another operation were much more important to those who chose mastectomy than those who opted for breast-conserving treatment. She also found some patients' choices were influenced by what they thought their surgeon wanted - more so in the breast-conserving treatment group.
Neutral patient guidance by surgeons might increase the rate of breast-conserving treatment to a level more consistent with larger New Zealand centres, she said.
