Receipt is significantly less common after mastectomy, even when it is strongly indicated

-- Rick Ansorge

Thursday, April 1, 2010 (Last Updated: 04/02/2010)

THURSDAY, April 1 (HealthDay News) -- In breast cancer patients, adjuvant radiotherapy receipt is consistently high after breast-conserving surgery but lower after mastectomy, even in patients for whom the treatment is strongly indicated, and surgeon involvement is a major influence on radiotherapy receipt, according to a study published online March 29 in the Journal of Clinical Oncology.

Reshma Jagsi, M.D., of the University of Michigan in Ann Arbor, and colleagues studied 2,260 women aged 20 to 79 with non-metastatic breast cancer who were diagnosed between July 2005 and February 2007 in Detroit and Los Angeles and reported to the Surveillance, Epidemiology, and End Results registries.

Among women with strong indications for adjuvant radiotherapy, the researchers found that receipt was higher in the 904 patients who underwent breast-conserving surgery than in the 135 patients who underwent mastectomy (95.4 versus 77.6 percent). Among women with weaker indications for radiotherapy, receipt was higher in the 114 patients who underwent breast-conserving surgery than in the 164 who underwent mastectomy (80 versus 47.5 percent). They found that the factors most significantly associated with a likelihood of receipt included surgery type, indication strength, age, comorbidity, income, patient desire to avoid radiotherapy, and level of surgeon involvement in the decision to have radiation.

"Radiotherapy receipt was consistently high across sociodemographic subgroups after breast-conserving surgery but was lower after mastectomy, even among patients with strong indications for treatment, in whom clinical benefit is similar. Surgeon involvement had a strong influence on RT receipt," the authors write.

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Family Practice
Internal Medicine

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