Comprehensive Cancer Control of South Dakota

Nancy Fahrenwald Shares Breast Cancer Treatment Research

The Women's Cancer Network sponsored Grand Rounds Lecture at the Sanford USD School of Medicine on October 24, 2012. Nancy Fahrenwald, PhD, shared findings from a study of South Dakota women diagnosed with early stage breast cancer and identified factors that influenced their treatment decision making. The study was funded by the American Cancer Society, Midwest Division.

Treatment options recommended by a surgeon were included among the factors that influence treatment choices. According to Dr. Fahrenwald, a surgeon's opinion was equally important to a woman's personal choice, along with fear of reoccurrence. Personal factors like age, other health issues, family history, work and care giving roles weigh heavily in women's decisions. Insurance coverage was also important. Treatment cost and distance were reported, but not as the most influential decision factors. Dr Fahrenwald also noted that more women from small rural areas choose mastectomy over lumpectomy with radiation in comparison to women from large rural areas.

The influence of geography, particularity distance to health care, was less of a concern than reported in other studies, according to Dr. Fahrenwald. "We were surprised that distance to treatment was not reported as one of the most important considerations." "We did find that women from urban areas - Rapid City or Sioux Falls - reported that distance to treatment was less important than it was for women from small rural communities."

Dr. Fahrenwald also noted that "more women from small rural areas choose mastectomy over lumpectomy with radiation in comparison to women from large rural areas - such as Aberdeen, Mitchell, Watertown, Yankton or Aberdeen." According to the American Cancer Society, mastectomy is a more invasive surgery in which all breast tissue is removed. Lumpectomy surgery removes only the cancerous and surrounding tissue and often requires subsequent radiation treatment. Previous studies have shown that lumpectomy plus radiation therapy has similar long-term survival rates as a mastectomy for women whose cancer has not spread to the skin, chest wall or other distant organs according to the American Cancer Society.

Women who participated in the study recommended that women who are making breast cancer treatment decisions find a physician and a health care team that they can trust, and that they take time to make the decision that is best for them. They also encouraged finding decision-making support from other breast cancer survivors. The American Cancer Society's Reach to Recovery is one such program that matches newly diagnosed breast cancer patients with survivors with a similar background.

Dr. Fahrenwald plans to publish the results in the South Dakota Journal of Medicine.

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Executive Summary

Comprehensive cancer control is an integrated and coordinated approach to reducing cancer incidence, morbidity, and mortality through prevention, early detection, treatment, rehabilitation & palliation.

- Centers for Disease Control & Prevention

The South Dakota Cancer Control Consortium is dedicated to bringing together individuals, organizations, health care providers, and agencies in order to reduce the burden that cancer places on the people of our state.

The South Dakota Comprehensive Cancer Control Plan is focused on prevention, early detection, treatment, data and research, survivor issues, and end of life/palliation. The plan includes the top priorities that cancer control professionals believe should be the focal point for immediate action in order to assure that it reflects the concerns of the people of the state. Their views are expressed throughout the plan.

The plan has the following components:

A look at how cancer affects South Dakota
Mission and goals of the project
Objectives and Strategies covering the following areas:
- Prevention
- Early Detection
- Treatment
- Quality of Life
- Resources