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

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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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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Authors and Affiliations

  1. Margie and Robert E. Petersen Breast Cancer Research Program, John Wayne Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA

    Julie A. Billar MD, Myung Shin Sim DrPH & Maureen Chung MD, PhD

Authors
  1. Julie A. Billar MD
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  2. Myung Shin Sim DrPH
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  3. Maureen Chung MD, PhD
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Correspondence to Maureen Chung MD, PhD.

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Billar, J.A., Sim, M.S. & Chung, M. Increased Use of Partial-Breast Irradiation Has Not Improved Radiotherapy Utilization for Early-Stage Breast Cancer. Ann Surg Oncol 21, 4144–4151 (2014). https://doi.org/10.1245/s10434-014-3867-3

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  • DOI: https://doi.org/10.1245/s10434-014-3867-3

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