ArticleBreast cancer research and treatment2021
Impact of age, rurality and distance in predicting contralateral prophylactic mastectomy for breast cancer in a Midwestern state: a population-based study.
Article in Breast cancer research and treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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Who cites it
11 citing papers in PubMed, 8 citations in OpenAlex.
- Breast cancer survival rates in Sarawak, Malaysia: a central referral centre study.BMC cancer · 2026Article
- A mixed-methods approach for understanding cancer center catchment area needs: An example of rural cancer disparities, needs, and resiliencies.Cancer causes & control : CCC · 2026Article
- Comparing Immediate Breast Reconstruction Rates in Rural and Urban Populations: A Global Systematic Review and Meta-Analysis: Comparer les taux de reconstruction mammaire immédiate dans les populations rurales et urbaines : une analyse systématique et méta-analyse globales.Plastic surgery (Oakville, Ont.) · 2026Review
- Impact of Travel Burden on Timeliness of Care and Overall Survival for Breast Cancer: A National Cancer Database Analysis.Cancer medicine · 2025Article
- Breast Cancer Myths, Mysterious Miracles and Mistrust among Rural Womenfolk in Sarawak.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Contralateral prophylactic mastectomy in a rural population: A single-institution experience.Surgery open science · 2024Article
- Effect of rurality and travel distance on contralateral prophylactic mastectomy for unilateral breast cancer.Cancer causes & control : CCC · 2023Article
- The Impact of Travel Distance and Income on Breast Reconstruction after Mastectomy in a Rural Population.Plastic and reconstructive surgery. Global open · 2023Article
- Influence of rurality on lymph node assessment among women diagnosed with ductal carcinoma in situ and treated with mastectomy, SEER 2000-2015.Breast cancer research and treatment · 2022Article
- Breast Cancer Disparities and the Impact of Geography.Surgical oncology clinics of North America · 2022Review
- Rurality predisposes departure from gold-standard care, leading to delayed or accelerated access to surgery: insights from a scoping review.Canadian journal of surgery. Journal canadien de chirurgieArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
purposeIowa is among several rural Midwestern states with the highest proportions of contralateral prophylactic mastectomy (CPM) in women < 45 years of age. We evaluated the role of rurality and travel distance in these surgical patterns.
methodsWomen with unilateral breast cancer (2007-2017) were identified using Iowa Cancer Registry records. Patients and treating hospitals were classified as metro, nonmetro, and rural based on Rural-Urban Continuum Codes. Differences in patient, tumor, and treatment characteristics and median travel distance (MTD) were compared. Characteristics associated with CPM were evaluated with multivariate logistic regression.
results22,158 women were identified: 57% metro, 26% nonmetro and 18% rural. Young rural women had the highest proportion of CPM (52%, 39% and 40% for rural, metro, nonmetro women < 40 years). Half of all rural women had surgery at metro hospitals; these women had the longest MTD (62 miles). Among all women treated at metro hospitals, rural women had the highest proportion of CPM (17% rural vs 14% metro/nonmetro, p = 0.007). On multivariate analysis, traveling ≥ 50 miles (ORs 1.43-2.34) and rural residence (OR = 1.29) were independently predictive of CPM. Other risk factors were young age (< 40 years: OR = 7.28, 95% CI 5.97-8.88) and surgery at a metro hospital that offers reconstruction (OR = 2.30, 95% CI 1.65-3.21) and is not NCI-designated (OR = 2.34, 95% CI 1.92-2.86).
conclusionThere is an unexpectedly high proportion of CPM in young rural women in Iowa, and travel distance and availability of reconstructive services likely influence decision-making. Improving access to multidisciplinary care in rural states may help optimize decision-making.
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