The effect of distance on the postoperative follow-up of patients with breast carcinoma.
OBJECTIVE
To assess the effect of in or out of city residence of patients with breast carcinoma, where breast surgery unit treatment and follow-up is made postoperatively.


METHODS
234 patients operated on for breast carcinoma at the Breast Surgery Unit were retrospectively studied. Patients were divided into two groups; patients living in the major city where the Breast Surgery Centre is located and patients living in smaller cities, districts, towns and villages out of the city. The distance of patients' residences from the Breast Centre has also been determined in kilometres. The number of patients and the frequency of check-up visits were compared in both groups.


RESULTS
The number of patients residing in the city centre where the Breast Unit is located was 156 (66.7%). Comparing the frequency of patients' visits for check-up during the postoperative period, there were no differences between the two groups during the first four years. However, the patients living out of the city did not visit the Breast Unit for check-ups during the fifth postoperative year. Moreover, when the patients were classified into two groups with known and unknown outcomes, it was observed that those patients with unknown outcomes lived further away from the city where the Breast Surgery Unit was located compared to those with known outcomes (p = 0.002).


CONCLUSIONS
Living within or out of the major city centre where the Breast Surgery Unit is located does not have any effect on the frequency of follow-up visits or the number of patients applying for check ups during the first four years postoperatively. However, there were gradual decreases over the course of time in both groups and these differences became apparent during the 5th year. In addition to this, the distance was also found to be an important factor for patients with unknown outcomes in the present study. The combination of living outside the city where The Breast Unit was located and the distance may have a negative effect on follow-ups. There is a need for new, larger scale, studies with longer follow-ups to show how this difference will change over a longer time period.
Kirdak
T
T
Department of Surgery, Uludag University School of Medicine, Bursa, Turkey. tkirdak@uludag.edu.tr
Paksoy
E
E
Sigirli
D
D
Tasdelen
I
I
Gokgoz
S
S
D000553:Ambulatory Care / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000601:surgery*; D002277:Carcinoma / Q000601:surgery*; D002947:Cities; D003266:Continuity of Patient Care; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012424:Rural Population; D013997:Time Factors; D014195:Travel; D014421:Turkey; D014505:Urban Population