SURGICAL-TREATMENT OF BREAST-CANCER IN NEW-SOUTH-WALES 1991, 1992

Background: The purpose of this study was to examine existing data on women diagnosed with breast cancer in New South Wales in 1991 and 1992 and to describe surgical treatments received on an inpatient basis. M ethods: Analyses were based on the linkage of two databases: the New S outh Wales Central Cancer Registry and the New South Wales Health Depa rtments Inpatient Statistics Collection. Data were limited to women wh o were resident and treated in New South Wales. Main analyses were res tricted to definitive surgical procedures. Results: Thirty-six per cen t of women treated surgically for breast cancer in 1991 had breast-con serving therapy. This had increased to 39% in 1992. There were substan tial geographical variations in the use of breast-conserving therapy i n New South Wales which could not be explained by patient characterist ics. Age, degree of spread at diagnosis, and area health service/healt h region were all found to have an independent association with the pr obability of having a mastectomy. Conclusions: Women with a localized degree of spread living in non-metropolitan areas (Health Regions) wer e almost twice as likely to have a mastectomy as compared with similar women who were resident in metropolitan areas (Area Health Services). The concentration of radiotherapy services may have contributed to th e urban/rural variation in breast-conserving therapy in New South Wale s, but it is also likely that some of the variations that were observe d may be a reflection of the failure of clinicians to use best current practice.