Patterns of utilization of adjuvant radiotherapy and outcomes in black women after breast conservation at a large multidisciplinary cancer center

Int J Radiat Oncol Biol Phys. 2011 Jul 15;80(4):1102-8. doi: 10.1016/j.ijrobp.2010.04.005.

Abstract

Purpose: Population-based studies have reported that as many of 35% of black women do not undergo radiotherapy (RT) after breast conservation surgery (BCS). The objective of the present study was to determine whether this trend persisted at a large multidisciplinary cancer center, and to identify the factors that predict for noncompliance with RT and determine the outcomes for this subset of patients.

Methods and materials: Between January 2002 and December 2007, 83 black women underwent BCS at Memorial Sloan-Kettering Cancer Center and were therefore eligible for the present study. Of the 83 women, 38 (46%) had Stage I, 38 (46%) Stage II, and 7 (8%) Stage III disease. Of the study cohort, 31 (37%) had triple hormone receptor-negative tumors. RT was recommended for 81 (98%) of the 83 patients (median dose, 60 Gy).

Results: Of the 81 women, 12 (15%) did not receive the recommended adjuvant breast RT. Nonreceipt of chemotherapy (p = .003) and older age (p = .009) were associated with nonreceipt of RT. With a median follow-up of 70 months, the 3-year local control, locoregional control, recurrence-free survival, disease-free survival, and overall survival rate was 99% (actuarial 5-year rate, 97%), 96% (actuarial 5-year rate, 93%), 95% (actuarial 5-year rate, 92%), 92% (actuarial 5-year rate, 89%), and 95% (actuarial 5-year rate, 91%), respectively.

Conclusion: We found a greater rate of utilization adjuvant breast RT (85%) among black women after BCS than has been reported in recent studies, indicating that excellent outcomes are attainable for black women after BCS when care is administered in a multidisciplinary cancer center.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Black or African American / statistics & numerical data*
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery
  • Cancer Care Facilities / statistics & numerical data
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Staging
  • New York City
  • Radiotherapy, Adjuvant / statistics & numerical data*
  • Radiotherapy, Adjuvant / trends
  • Sentinel Lymph Node Biopsy / statistics & numerical data
  • Survival Rate
  • Treatment Outcome