Table 54: Regional differences in rates of mastectomy in the U.S.

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s 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 vary by region in the U.S. The lowest rates of mastectomy (and thus, the highest rates of lumpectomy) are on the East and West Coasts, with the highest rates in the Northeast [1-3].

The table below shows the differences in U.S. mastectomy rates for women ages 65 and older.

Mastectomy for Breast Cancer by State, 2012 (among women enrolled in Medicare) View an interactive map of these mastectomy rates.
State	Mastectomy (per 100,000 women)	State	Mastectomy (per 100,000 women)
Alabama	64	Montana	70
Alaska	Not available	Nebraska	54
Arizona	55	Nevada	38
Arkansas	65	New Hampshire	25
California	61	New Jersey	59
Colorado	35	New Mexico	43
Connecticut	80	New York	68
Delaware	27	North Carolina	34
District of Columbia	Not available	North Dakota	103
Florida	49	Ohio	49
Georgia	42	Oklahoma	80
Hawaii	Not available	Oregon	64
Idaho	52	Pennsylvania	74
Illinois	68	Rhode Island	45
Indiana	65	South Carolina	56
Iowa	42	South Dakota	91
Kansas	32	Tennessee	50
Kentucky	58	Texas	54
Louisiana	50	Utah	71
Maine	50	Vermont	23
Maryland	61	Virginia	54
Massachusetts	54	Washington	58
Michigan	76	West Virginia	78
Minnesota	81	Wisconsin	50
Mississippi	112	Wyoming	Not available
Missouri	41	United States	58
Soure: The Dartmouth Atlas of Health Care, 2015 [3]

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

Rates of lumpectomy and mastectomy can differ based on where a woman lives. Radiation therapy is needed after a lumpectomy. So, women who have to travel a long distance to get radiation therapy may prefer to have a mastectomy. Personal preference is also important. Some women very much wish to keep their breasts, while for other women mastectomy offers peace of mind.

Differences can also occur when women do not understand the risks and benefits of lumpectomy and mastectomy. Lumpectomy plus radiation therapy is not an option for all women. Talk with your health care provider about whether it is an option for you. Learning about the risk and benefits of 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

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.
Habermann EB, Abbott A, Parsons HM, Virnig BA, Al-Refaie WB, Tuttle TM. Are mastectomy rates really increasing in the United States? J Clin Oncol. 28(21):3437-41, 2010.
The Dartmouth Atlas of Health Care. Inpatient mastectomy for cancer. http://www.dartmouthatlas.org, 2015.