Mastectomy as the preferred treatment for breast cancer among new immigrants from the former USSR.

Sixty-four new immigrant patients with primary breast cancer who arrived in Israel since 1990 were compared to 322 Israeli women with primary breast cancer. New immigrant patients had a more advanced stage at diagnosis (stage III+IV 28% vs. 13% respectively, P = 0.00005); larger mean tumor size (3.08 +/- 1.7 cm vs. 2.25 +/- 1.4 cm respectively, P = 0.00002); and more involved lymph nodes (3.8 +/- 5.3 vs. 1.8 +/- 3.3 P = 0.0002). Forty-seven percent of new immigrants had breast-conserving surgery compared to 69% of the Israelis (P = 0.0004). In stage II 51% of the new immigrants had conservative surgery compared to 74% in the Israeli group (P = 0.03). Mastectomy was recommended to 39 Israeli patients and to six immigrants. Only 19% of the Israeli group requested mastectomy compared to 44% in the new immigrant group. Most of the new immigrant patients chose mastectomy although breast-conserving surgery was an equal alternative. The reasons for choosing mastectomy as the preferred mode of treatment were related to economic problems, different life concepts, and other priorities. Constant surveillance and considerable enlightenment are needed in the new immigrant population, so that they will be able to separate the disease and its treatment from their paramedical problems.