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Surgical Services for Breast Cancer Patients in Australia, is There a Gap for Aboriginal and/or Torres Strait Islander Women?

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Abstract

Background

Breast cancer is the most commonly diagnosed cancer in Aboriginal and/or Torres Strait Islander women. When compared to other Australians, Aboriginal and/or Torres Strait Islander women have a higher breast cancer mortality rate. This systematic literature review examined disparities in breast cancer surgical access and outcomes for Aboriginal and/or Torres Strait Islander women.

Methods

This systematic literature review, following the PRISMA guidelines, compared measures of breast cancer surgical care for Aboriginal and/or Torres Strait Islander people and other Australians.

Results

The 13 included studies were largely state-based retrospective reviews of data collected prior to the year 2012. Eight studies reported more advanced breast cancer presentation among Aboriginal and/or Torres Strait Islander women. Despite the increased distance to a multidisciplinary, specialist team, there were no disparities in seeing a surgeon, or in the time from diagnosis to surgical treatment. Two studies reported disparities in the receipt of surgery and two reported no variations. Three studies reported disparities in the receipt of mastectomy versus breast conserving surgery, whilst four studies reported no variations. No studies examined postoperative surgical outcomes.

Conclusions

Aboriginal and/or Torres Strait Islander women present with more advanced breast cancer. There may be disparities in the receipt of surgery and the type of surgery. However, the metrics tested were not related to optimal care guidelines, and the databases utilised contain limited data on individual factors contributing to surgical care decisions. It is therefore difficult to determine whether the reported differences in the receipt of surgical care reflect disparate or appropriate care.

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Acknowledgements

Elzerie de Jager is a Doctor of Philosophy candidate at an Australian university; this research degree is supported by an Australian Government Research Training Program (RTP) Scholarship. This work is also supported by the Avant Doctor in Training Research Scholarship.

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Authors and Affiliations

  1. College of Medicine and Dentistry, The James Cook University, 1 James Cook Drive, Townsville, QLD, 4811, Australia

    Elzerie de Jager & Yik-Hong Ho

  2. General Practice/ Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, PO BOX 453, 405 30, Goteborg, Sweden

    Ronny Gunnarsson

  3. Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Sweden

    Ronny Gunnarsson

  4. Townsville Clinical School, The Townsville Hospital, 100 Angus Smith Drive, Townsville, QLD, 4818, Australia

    Yik-Hong Ho

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  1. Elzerie de Jager
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Correspondence to Elzerie de Jager.

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de Jager, E., Gunnarsson, R. & Ho, YH. Surgical Services for Breast Cancer Patients in Australia, is There a Gap for Aboriginal and/or Torres Strait Islander Women?. World J Surg 46, 612–621 (2022). https://doi.org/10.1007/s00268-021-06310-1

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