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Mastectomy rates vary widely across Canada

Written by: QMI Agency
Oct. 11, 2012

Rates of mastectomy vary widely across Canada. (Fotolia)

Mastectomy rates for women vary widely across Canada, ranging from 26% in one province to 69% in another, and the surgery is performed on a large proportion of women under 50, a new report has found.

The Canadian Institute for Health Information examined three years' worth of data on approximately 22,000 women treated surgically for breast cancer, both the "invasive" form of the disease and the "non-invasive" form (called ductal carcinoma in situ, or DCIS).

Most women are offered surgery as part of their treatment - either mastectomy or "breast-conserving surgery" (BCS, commonly called a lumpectomy) with radiation therapy. The survival rates between the two treatments are comparable for women diagnosed with smaller tumours, but BCS is preferable because it is less invasive.

Even so, between 2007 and 2010, more than two-thirds (67%) of DCIS patients in Newfoundland and Labrador received a mastectomy -- the highest rate in the country. The next highest were Alberta and Saskatchewan, at 48% and 45%, respectively. That's in contrast to Quebec, the province with the lowest rate in the country, where just 17% of breast cancer patients received a mastectomy. Elsewhere in Canada, the surgery was performed between 28 and 35% of the time.

The rates were similar for women with unilateral invasive breast cancer (cancer in one breast), ranging from 69% in N.L. to 26% in Que.

The study notes that it is relatively common for women who undergo a lumpectomy to require further surgery to remove additional tissue. Once again, the re-excision rate varied significantly across the country: from 56% in N.L. to 17% in Manitoba and Quebec.

The study found a relationship between mastectomy rates and a patient's travel time to reach a treatment centre.

"Women whose residence placed them far from a cancer centre that has a radiation facility had higher rates of mastectomy," the CIHI found. "Travel time ... appears to significantly reduce the use of less-invasive surgery for breast cancer."

There was also an age gap: mastectomy was used to treat 44% of women under 50 -- a "relatively high" number, according to the report -- but 35% of women aged 50-69. The rate goes up again to 45% for women 70 and older.

The CIHI estimates that about 22,700 women in Canada will be diagnosed with invasive breast cancer this year.

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