Inequity in Mammographic Surveillance following Breast Cancer in Taranaki

Authors List

Joret, M., Taranaki Base Hospital, New Plymouth, New Zealand  Davenport, E., Taranaki Base Hospital, New Plymouth, New Zealand

Introduction: The New Zealand guidelines on the management of early breast cancer recommend annual surveillance mammography in patients who have undergone treatment for breast cancer. Early mammographic detection of recurrent locoregional disease in asymptomatic patients has been shown to improve patient survival over late symptomatic detection (Lu et al., 2009). Breast-cancer-specific diagnosis, treatment, and survival inequities exist in New Zealand (Tin Tin et al., 2018). The rates of surveillance mammography uptake in New Zealand have, to date, not been studied.

Aim:
To examine rates of annual surveillance mammography uptake in Taranaki patients following breast cancer treatment and to assess differences between socio-demographic groups.

Methods:
195 consecutive patients who received potentially curative treatment for breast cancer in Taranaki between January 2008 and December 2010 were reviewed. Annual surveillance mammography compliance over the 10 years following initial diagnosis was assessed and differences between socio-demographic groups were analysed.

Results:
Patients received an average of 6 mammograms in the 10 years following breast cancer diagnosis. When accounting for patients who died or moved out of area, 66.7% of all mammogram opportunities were fulfilled. Māori patients (55% vs 68 %, p=0.008) and patients living further than 10 kilometres away from their radiology centre (61% vs 71%, p=0.004) received significantly fewer surveillance mammograms.

Conclusions:
Breast cancer survivors in Taranaki only receive approximately two thirds of the recommended annual surveillance mammograms in the 10 years following diagnosis. Disparities exist for Māori patients and those living outside our region’s main urban centre. Our results highlight further ethnic and rural inequities in the care of patients with breast cancer in New Zealand.

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