There is a greater chance general surgeons in regional NSW will cut out vital lymph nodes during mastectomies, according to esteemed private practice director, Doctor Helen Mackie.

This increases the chance of lymphoedoema, a disease that causes swollen limbs and rapid weight gain.

Dr Mackie, director of lymphology at Mt Wilga Private Hospital at Hornsby in Sydney, a nationally recognised establishment with lymphoedoema specialists, said a quarter of mastectomy patients get lymphoedoema because of lymph node removal and “about 10 per cent of these cases will be quite severe”.

The probability of getting lymphoedoema worsens with radiation treatment.

Four lymphoedoema patients come to the Hornsby hospital weekly and “one or two” are from rural and regional areas.

Cities have greater populations to justify sentinel node dissection, the practice of cutting out only the cancerous lymph nodes instead of all of them.

“A surgeon in the country may be less likely to do the specialist surgery,” said Dr Mackie, also a medical adviser to the Australian Lymphology Association.

In the past 18 months there have been at least 623 breast surgeries, including lesion removal, in the three health services covering rural NSW.

Three health service media officers said public hospitals at Dubbo, Bathurst, Orange, Albury, Wagga Wagga, Bega, Moruya, Tamworth, Goulburn and the Manning were all able to do sentinel node surgery.

Meanwhile, a Central West Anglican minister, Ted Evenden, wants more rural physiotherapists throughout NSW trained in lymphatic drainage massage.

Every weekday “Father Ted”, as residents call him, self treats for one hour and receives one hour’s massage from a therapist at Yeoval UPA Aged Care Centre.

“There are quite a few people in the coastal regions aware and treating people but it really needs to be wider spread,” he said.