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Cities show big disparity in breast-sparing surgery

SHARE Cities show big disparity in breast-sparing surgery

A survey of ZIP codes shows the chances of someone having a cancerous breast removed verses a less radical procedure are greater in Ogden or Provo than in Salt Lake City.

The recent Dartmouth Atlas of Health, which compiled Medicare data from every ZIP code in the United States in 1994 and 1995, found that the rate of mastectomies in Ogden and in Provo is 2.7 per 1,000 female enrollees. The rate in Salt Lake City is 1.8 per 1,000."If you drove from Ogden to Salt Lake City, it could really increase the chance of having breast-sparing surgery," said atlas editor Megan McAndrew Cooper.

The national average is 2.2 per 1,000.

Reasons for these variations are being studied by the Utah Triad Clinical Cancer Control Program, said Carrie Briscoe, McKay-Dee Hospital's cancer data manager.

The Triad consists of Hospital Cancer Liaison Physicians, the Utah Association of Cancer Registrars and the Utah Division of the American Cancer Society.

Dr. Charles Smart, chairman of the liaison program and medical consultant for the Utah Cancer Registry, said the preliminary data on 3,191 Utah women diagnosed with invasive breast cancer between 1990 and 1995 says 35 percent received breast-conserving surgery.

The percentage varies by county and is highest where radiation therapy centers exist, which is 30 percent in Weber, 47 percent in Salt Lake and 37 percent in Utah County.

Breast-conserving surgeries, such as lumpectomies, are almost always coupled with radiation treatment to assure the elimination of the cancer.

That might be one explanation for the varying rates, according to breast cancer survivor Sheree Berryman, who works as an American Cancer Society volunteer. She said people who live in more rural areas may choose a mastectomy so they don't have to travel for daily radiation treatments.

But Briscoe said some women opt for mastectomies over lump-ec-tomies, even if they live close to a radiation therapy center, because they don't want radiation.

Dr. Regina Klein, a medical oncologist in Layton and Bountiful, said the decision may be based on the size of the tumor or the threat of the cancer spreading. The physician's expertise may also be a factor.