The use of radiation therapy after breast-conserving surgery in hormonally treated breast cancer patients is dependent on patient age, geographic region, and surgeon specialty

American Journal of Surgery
Anees B ChagparMichael J Edwards

Abstract

The use of radiation therapy (RT) after breast-conserving surgery (BCS) is inconsistent in patients treated with hormonal therapy (HT). We sought to identify factors influencing the decision to use RT in this setting. Patients in the North American Fareston vs. Tamoxifen Adjuvant (NAFTA) trial who had BCS were evaluated for factors influencing the use of RT using univariate and multivariate analyses. Of the 1,811 patients enrolled in the NAFTA trial, 1,222 (67.4%) had BCS. Of these, 241 (19.7%) did not have RT. There were no significant differences in tumor grade, lymphovascular invasion, estrogen receptor status, or nodal status between those who received RT and those who did not. On univariate analyses, patients who did not receive RT were more likely to be older (median 72 versus 66 years, P < .001), have larger tumors (median 1.35 versus 1.10 cm, P = .009), and be progesterone negative (18.3% versus 13.1%, P = .048). Surgeons in the West were most likely to omit RT, whereas those in the Midwest were least likely to omit it (26.7% versus 7.2%, P < .001). Surgical oncologists were more likely to omit RT after BCS than general surgeons (21.8% versus 13.7%, P < .001). Academic affiliation (P < .001), number of breast procedures...Continue Reading

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Citations

Jul 25, 2013·Breast Cancer Research and Treatment·Stanimira KrotnevaAri N Meguerditchian
Mar 10, 2012·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Scarlett Lin GomezAllison W Kurian
Nov 16, 2010·International Journal of Radiation Oncology, Biology, Physics·Chun-Ru ChienYa-Chen Tina Shih
Apr 28, 2009·International Journal of Radiation Oncology, Biology, Physics·Benjamin D SmithThomas A Buchholz
Apr 1, 2015·Journal of Comparative Effectiveness Research·Parul N Barry, Anthony E Dragun
Dec 8, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Grace L SmithYa-Chen T Shih
Mar 20, 2021·Annals of Surgical Oncology·Harriet Eldredge-HindyNicolas Ajkay
May 11, 2020·International Journal of Radiation Oncology, Biology, Physics·Harriet Eldredge-HindyNicolas Ajkay

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