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Home > Understanding Breast Cancer > Breast Cancer Research > Table 54: Regional differences in rates of mastectomy in the United States

  


Table 54: Regional differences in rates of mastectomy in the United States

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: Lumpectomy (also called breast conserving surgery) plus radiation therapy is as effective as mastectomy in treating early breast cancer (see Table 37). However, rates of these procedures in the United States vary by region. For women of all ages, the lowest rates of mastectomy (and therefore the highest rates of lumpectomy) occur on the East and West Coasts [1-5].

The table below shows the differences in mastectomy rates for women ages 65 and older in the US. Find an interactive map showing these mastectomy rates

 

Mastectomy for Breast Cancer by State, 2007
(among women enrolled in Medicare)
Find an interactive map showing these mastectomy rates.

 State 

 Mastectomy
(per 100,000 women)
 

 State 

 Mastectomy
(per 100,000 women)
 

Alabama

141

Montana

130

Alaska

Not available

Nebraska

116

Arizona

114

Nevada

79

Arkansas

127

New Hampshire

47

California

93

New Jersey

104

Colorado

70

New Mexico

72

Connecticut

122

New York

95

Delaware

63

North Carolina

101

District of Columbia

105

North Dakota

174

Florida

98

Ohio

83

Georgia

98

Oklahoma

127

Hawaii

52

Oregon

86

Idaho

98

Pennsylvania

101

Illinois

97

Rhode Island

94

Indiana

76

South Carolina

100

Iowa

120

South Dakota

182

Kansas

88

Tennessee

110

Kentucky

102

Texas

99

Louisiana

132

Utah

61

Maine

98

Vermont

36

Maryland

83

Virginia

83

Massachusetts

68

Washington

88

Michigan

112

West Virginia

107

Minnesota

138

Wisconsin

111

Mississippi

158

Wyoming

143

Missouri

93

United States

100

Soure: The Dartmouth Atlas of Health Care, 2012 [5]

 

 

Why are there regional differences in rates of mastectomy and lumpectomy plus radiation therapy?

Part of the difference in regional rates of mastectomy for women with early breast cancer is due to personal choice. Younger women may prefer to have a lumpectomy plus radiation. Women who live in areas far from a center that offers radiation therapy (needed for lumpectomy) also may prefer to have a mastectomy. And, mastectomy can offer some women peace of mind with less worry about recurrence.

However, differences in rates also can occur when women who are candidates for lumpectomy are not encouraged by their health care providers to have the procedure. Learning about your surgery options and talking with your provider about which treatments are best for you can help you feel confident that you are getting the best care possible. You should never hesitate to seek a second or even a third opinion from providers at different hospitals or practices.

Learn more about lumpectomy and mastectomy.

Learn more about getting good care.

References  

1. Du X, Freeman JL, Freeman DH, et al. Temporal and regional variation in the use of breast-conserving surgery and radiotherapy for older women with early-stage breast cancer from 1983 to 1995. Journal of Gerontology: Medical Sciences. 54(9):M474-78, 1999.

2. Lazovich D, Solomon CC, Thomas DB, et al. Breast conservation therapy in the United States following the 1990 National Institutes of Health Consensus Development Conference on the Treatment of Patients with Early Stage Invasive Breast Carcinoma. Cancer. 86:628-37, 1999.

3. White J, Morrow M, Moughan J, et al. Compliance with breast-conservation standards for patients with early-stage breast carcinoma. Cancer. 97(4):893-904, 2003.

4. Smith GL, Xu Y, Shih YC, et al. Breast-conserving surgery in older patients with invasive breast cancer: current patterns of treatment across the United States. J Am Coll Surg. 209(4):425-433.e2, 2009.

5. The Dartmouth Atlas of Health Care. Inpatient mastectomy for cancer. http://www.dartmouthatlas.org/data/table.aspx?ind=95, 2012.

Updated 12/18/12