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Lower Breast Cancer Survival Rates for Disabled Women

Fewer disabled women receive breast-conserving treatment, radiotherapy, lymph node dissection

TUESDAY, Nov. 7 (HealthDay News) -- Women with disabilities have a higher mortality rate from breast cancer and are less likely to undergo standard therapy after breast-conserving surgery, according to the results of a study published in the Nov. 7 issue of the Annals of Internal Medicine.

Ellen P. McCarthy, Ph.D., M.P.H., from Beth Israel Deaconess Medical Center in Brookline, Mass., and colleagues conducted a retrospective cohort study of 100,311 women diagnosed with stage I to IIIA breast cancer from 1988 to 1999. Treatment and survival data were compared between women with and without disabilities according to their qualification for Medicare and Social Security Disability Insurance.

Disabled women had lower overall survival and breast cancer-specific survival than other women (hazard ratio, 2.02 and 1.31, respectively). Disabled women also had lower rates of breast-conserving surgery than other women (43.2 versus 49.2 percent) and disabled women that had surgery were less likely to receive radiation therapy and axillary lymph node dissection.

"Whether the cause of these differences in care is physician bias or patient preference is unknown, but the search for the causes need not delay a solution," according to David Casarett, M.D., M.A., in an accompanying editorial. "Physicians must talk to their patients about their preferences for treatment and their knowledge of the options."

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