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Patient Views and Correlates of Radiotherapy Omission in a Population-Based Sample of Older Women with Favorable Prognosis Breast Cancer
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7 01 2018
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Source: Cancer. 124(13):2714-2723
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Alternative Title:Cancer
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Personal Author:
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Description:Background
Radiotherapy omission after lumpectomy is a reasonable option for many older women with favorable prognosis breast cancer. We sought to evaluate patient perspectives regarding decision-making about radiotherapy (RT).
Methods
Women age 65–79 with stage I and II breast cancer reported to the Georgia and Los Angeles County SEER registries were surveyed (response rate=70%) regarding radiotherapy decisions, the rationale for omitting RT, decision-making values, and understanding of recurrence risk. We also surveyed their corresponding surgeons (response rate=77%). We evaluated patient characteristics associated with omission of RT using multilevel, multivariable logistic regression, accounting for patient clustering within surgeons.
Results
Of 999 patients, 135 omitted RT (14%). Older age, lower grade, and estrogen receptor-positive disease were each strongly associated with omission of RT in multivariable analyses, whereas number of comorbidities was not. Non-English speakers were more likely to omit RT (adjusted OR 5.9, 95% CI 1.4–24.5).
Conclusions
To some extent, decisions about radiotherapy omission are appropriately influenced by age, grade, and estrogen receptor status, but do not appear to be optimally tailored according to competing comorbidities. Many women who are candidates for radiotherapy omission overestimate their risk of recurrence.
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Pubmed ID:29669187
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Pubmed Central ID:PMC7537366
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