The use of radiation therapy following breast conserving surgery (BCS) is an important component of the treatment of breast cancer. In a state with a geographically disparate population, accessibility of radiation treatment facilities may impact patient’s treatment options. We explored trends of BCS vs mastectomy and radiation therapy (RT) utilisation rates among Queensland breast cancer patients.
Data on Queensland women diagnosed with breast cancer between 2000 and 2014 were sourced from the Queensland Oncology Repository. Surgical treatment data was inspected to assess patterns of breast conserving surgery (BCS)/mastectomy as first treatment. RT data coverage was complete from 2007 onwards and we describe utilisation rates among women whose only surgical treatment was BCS.
There were over 36,000 women diagnosed with breast cancer during 2000-2014 and the proportion of breast cancer patients undergoing BCS alone has decreased slightly over this period, from 59% of all surgical patients in 2000-2006 to 56% during 2007-2014. Subsequent RT was delivered to over 89% of BCS patients during the 2007-2014 period. Utilisation rates were highest for women aged 40-49 (95%) and lowest among women aged 80+ (44%). Urban (90%) and rural (88%) patients exhibited similar rates of radiotherapy, and similarly disadvantaged patients (89%) did not appear to encounter barriers to accessing radiotherapy compared with affluent patients (92%). Patients identifying as indigenous experienced high rates of radiotherapy (97%) though only a small proportion of the 12,000 BCS patients during 2007-2014 were identified as indigenous (n=132).
Despite the challenges of delivering cancer treatment in a geographically diverse population, Queensland breast cancer patients across the state benefit from equitable access to radiotherapy. Radiation therapy services are being delivered in locations which enable high utilisation rates among population groups who may have traditionally faced barriers to accessing health services more broadly.