Effect of social class on tumour size at diagnosis and surgical treatment in Danish women with breast cancer

This study examines the effect of socio-economic inequalities on the tumour size at diagnosis and the choice of surgical treatment in Danish women wit h breast cancer. The Danish Breast Cancer Cooperative Group (DBCG) register s all women with breast cancer in Denmark and provides clinical register da ta on tumour size and surgical treatment for 1593 women < 75 yr diagnosed w ith breast cancer between 1991 and 1996. A questionnaire including question s on social class was sent to the women. The tumour size at diagnosis (an i ndicator of access to treatment) and the surgical procedure (lumpectomy or mastectomy) for patients who were potential candidates for lumpectomy were the main outcome measures examined. Social class was not associated with tu mour size at diagnosis. The tumour size war associated with age and the exi stence of a mammographic screening program in the county. However, treatmen t was strongly related to social class. Among women considered candidates f or lumpectomy 77% underwent lumpectomy in the highest social class, compare d to 50% in the lowest social class. treatment was associated with age, tum our size and hospital status. It was concluded that the study showed no soc io-economic inequalities related to access to health services as measured b y tumour size, though significant social differences were found regarding t reatment. (C) 1998 Elsevier Science Ltd. All rights reserved.