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


Authors: Edwards-Bennett, S. M.; Jacks, L. M.; McCormick, B.; Zhang, Z.; Azu, M.; Ho, A.; Powell, S.; Brown, C.
Article Title: Patterns of utilization of adjuvant radiotherapy and outcomes in black women after breast conservation at a large multidisciplinary cancer center
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. © 2011 Elsevier Inc.
Keywords: adult; aged; survival rate; major clinical study; overall survival; doxorubicin; fluorouracil; cancer combination chemotherapy; paclitaxel; cancer radiotherapy; disease free survival; chemotherapy; methotrexate; outcome assessment; follow up; breast cancer; radiotherapy; cyclophosphamide; groups by age; cancer center; disease severity; partial mastectomy; patient compliance; local control; external beam radiotherapy; cancer control; disease control; locoregional control; adjuvant radiotherapy; diseases; breast conservation; overall survival rates; recurrence-free survival; rt; black women; breast conservation surgery
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 80
Issue: 4
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2011-07-15
Start Page: 1102
End Page: 1108
Language: English
DOI: 10.1016/j.ijrobp.2010.04.005
PROVIDER: scopus
PUBMED: 20598458
DOI/URL:
Notes: --- - "Export Date: 17 August 2011" - "CODEN: IOBPD" - "Source: Scopus"
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MSK Authors
  1. Alice Yoosun Ho
    122 Ho
  2. Zhigang Zhang
    427 Zhang
  3. Simon Nicholas Powell
    331 Powell
  4. Carol Brown
    167 Brown
  5. Michelle Chinwe Azu
    3 Azu
  6. Beryl McCormick
    371 McCormick
  7. Lindsay Jacks
    37 Jacks