were no significant mortality differences between the two groups, researchers found that rural women were less likely to have their estrogen receptor status tested and their tumor graded—two important elements of the diagnostic work-up for breast cancer.

In addition, rural women were also more likely to choose mastectomy, which is complete removal of the breast, than lumpectomy.

Rural women choosing lumpectomy were less likely to get the recommended radiation therapy following surgery, the study found.

"The lumpectomy findings are worrisome because lack of follow-up radiation therapy could lead to recurrence, another surgery, and another time period of concern for the woman and her family," Habermann says.

The researchers recommend further research to determine why rural women are less likely to choose breast-conserving therapy and get recommended cancer diagnosis and treatment. Interventions then could be designed to address the gaps, they say.

The study was supported by National Institutes of Health grants.

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