Ethnic, socio‐demographic and socio‐economic differences in surgical treatment of breast cancer in New Zealand
Many non‐tumour‐related factors including age, comorbidity, patient/surgeon preference and availability and access to healthcare services have been shown to influence the decision on type of surgical treatment for breast cancer.8 Many of these factors also contribute to ethnic, socio‐economic and geographic variations in quality and type of surgical care, which are well documented from many countries.9 These variations include lower rates of BCS, SNB, post‐mastectomy breast reconstruction and definitive local therapy among women of minority/Indigenous ethnicity, lower socio‐economic status and rural residency.12
Indigenous Māori women in New Zealand are known to experience inferior quality of cancer treatment compared with NZ Europeans for many cancers.15 For example, Māori have been reported to have a lower likelihood of undergoing surgery for operable lung cancer,15 and to experience longer delays for surgical treatment of breast and lung cancer compared with NZ European patients.15 At present, limited data are available on quality or types of surgical treatment received by women with breast cancer in New Zealand19 or possible ethnic differences in such treatment. We investigated differences in rates of BCS, SNB, post‐mastectomy breast reconstruction and definitive local therapy for breast cancer by ethnicity among a cohort of women with invasive breast cancer in New Zealand. We also investigated tumour and socio‐demographic factors associated with these differences, and time trends in disparities in surgical care between Māori and NZ European women.