“This finding dispels prior evidence that women who must travel further choose a mastectomy,” Fahrenwald said, noting that “this will impact people’s thinking about rurality.”
When looking at age as a determining factor, the nursing researchers found that 20- to 30-year-olds and those older than 75 tended to choose the more surgically invasive treatments, Fahrenwald explained. Young women with early-stage cancer in one breast chose bilateral mastectomy, often with reconstruction, then chemotherapy and even gene therapy. However, Ommen found that statistically, age was not a major factor in treatment choice.
Considering both options After narrowing the analysis down to those women who discussed both lumpectomy and mastectomy with their surgeons, Ommen concluded that the most significant factor to predict treatment choice is the stage of the woman’s breast cancer. She also verified the logistic analysis using reverse stepwise procedure for regression.
Among the 415 women who considered both options, 109 were at Stage 0, 186 at Stage 1, and 120 at Stage 2. The majority of those at Stage 0 and Stage 1 chose lumpectomy, 57.7 percent and 65.6 percent respectively, which shows that a statistically significant relationship was observed, Ommen explained.
However, the women with Stage 2 cancer had a tendency to choose the more surgically extensive treatments with nearly 58 percent opting for mastectomy, according to Ommen. “Getting the disciplines together means you get a better product,” said Saunders, who views statistics as a supportive discipline.
This collaborative work will provide “statistically rigorous justification for the relationships that are leading to perceptions that rural community members are choosing mastectomy,” Fahrenwald said. That will then help formulate public health policies to encourage patient-centered treatment decisions where options are provided and women make an informed choice and are highly satisfied with that choice.
About South Dakota State UniversityFounded in 1881, South Dakota State University is the state’s Morrill Act land-grant institution as well as its largest, most comprehensive school of higher education. SDSU confers degrees from eight different colleges representing more than 175 majors, minors and specializations. The institution also offers 29 master’s degree programs, 15 Ph.D. and two professional programs.
The work of the university is carried out on a residential campus in Brookings, at sites in Sioux Falls, Pierre and Rapid City, and through Cooperative Extension offices and Agricultural Experiment Station research sites across the state.