"The concepts saint and Mary evoke quite different connotations in Italy. A saint is much more likely to be associated with the local community. A saint, for example, is likely the protector of that community. The local church will likely be dedicated to a saint. Most of the images that peer down from the altars in that church will be the images of saints. A saint, in other words, is someone close and accessible. "Madonnas, however, are distant. In part, distance is established by the fact already mentioned--that madonnas are more likely than saints to be associated with sanctuaries far away from population centers. This is not to deny that some madonna cults grow up in urban areas. On the contrary, it is quite common to hear about an outdoor image of Mary in some city that suddenly starts dispensing favors, becomes the object of popular devotion, and is then brought into a church. But these are not usually powerful madonnas; the most powerful madonnas in Italy are almost always those whose images are kept in distant rural sanctuaries."
Carroll, Michael P. Madonnas that Maim. p. 26.