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Annals of Surgical Oncology

, Volume 21, Issue 13, pp 4144–4151 | Cite as

Increased Use of Partial-Breast Irradiation Has Not Improved Radiotherapy Utilization for Early-Stage Breast Cancer

  • Julie A. Billar
  • Myung Shin Sim
  • Maureen Chung
Breast Oncology

Abstract

Background

Radiotherapy (RT) reduces local recurrence after breast-conserving surgery (BCS) for breast cancer, but under-utilization of RT has been reported. Accelerated partial-breast irradiation (PBI) improves RT accessibility, but it is uncertain if this has improved RT utilization.

Methods

The Surveillance, Epidemiology and End Results registry was used to identify women who underwent BCS for stage 0 or 1 breast cancer from 2000 to 2009. Temporal trends in RT utilization and RT modality were determined. Chi-square analysis and multivariate logistic regression identified predictors of RT utilization and modality.

Results

Of 180,219 study patients, 131,343 (73 %) received RT; 123,703 (94 %) of RT recipients received whole-breast irradiation (WBI) and 6,251 (5 %) received PBI. PBI rates increased dramatically during the study period (0.32 % in 2000 vs. 6.5 % in 2009), but overall RT utilization remained relatively stable because of a decline in WBI (69.8 % in 2000 vs. 62.4 % in 2009). RT utilization was unchanged in rural counties, and declined for women <40 and ≥70 years of age, and for Native American, Asian and Hispanic patients. White and Black women used PBI most frequently (4 % each) and were the only race groups with improved RT utilization over time. Predictors of RT usage included age, race, marital status, tumor size, grade, hormone receptor status, lymph node evaluation, geographic region, metropolitan status, education, and employment status.

Conclusions

Women who undergo RT are opting for PBI more frequently, but the increased use of this modality has not improved overall RT utilization for patients with early-stage breast cancer.

Keywords

Radiation Therapy Modality Hormone Receptor Status Radiation Therapy Utilization Short Treatment Regimen Deferred Radiation Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

The authors would like to thank the John Wayne Cancer Institute Auxiliary for fellowship support, and Gwen Berry for editorial assistance.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Julie A. Billar
    • 1
  • Myung Shin Sim
    • 1
  • Maureen Chung
    • 1
  1. 1.Margie and Robert E. Petersen Breast Cancer Research ProgramJohn Wayne Cancer Institute at Providence Saint John’s Health CenterSanta MonicaUSA

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