Risk Factors for Poorer Breast Cancer Outcomes in Residents of Remote Areas of Australia

To investigate patient, cancer and treatment characteristics in females with breast cancer from more remoteareas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyseswere undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australiaand New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socioeconomicstatus and be treated in earlier diagnostic epochs and at inner regional and remote rather than majorcity centres. They were also more likely to be treated by low case load surgeons, although this finding was onlyof marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas wereless likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy,and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate ofadjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgeryand adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancercentres recently funded to improve service access in these areas.