Patient Views and Correlates of Radiotherapy Omission in a Population-Based Sample of Older Women with Favorable Prognosis Breast Cancer

Details

• Alternative Title:
  Cancer
• Personal Author:
  Shumway, Dean ; Griffith, Kent A. ; Hawley, Sarah T. ; Wallner, Lauren P. ; Ward, Kevin C. ; Hamilton, Ann S. ; Morrow, Monica ; Katz, Steven ; Jagsi, Reshma
• 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.
• Subjects:
  • Age Factors
  • Aged
  • Breast Neoplasms
  • Decision Making
  • Female
  • Georgia
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Los Angeles
  • Mastectomy, Segmental
  More +
• Keywords:
  • breast cancer
  • radiotherapy omission
  • risk perception
  • geriatric oncology
  • decision-making
• Source:
  Cancer. 124(13):2714-2723
• Pubmed ID:
  29669187
• Pubmed Central ID:
  PMC7537366
• Document Type:
  Journal Article
• Funding:
  P30 AG024824/AG/NIA NIH HHSUnited States/ ; HHSN261201000015I/CA/NCI NIH HHSUnited States/ ; U58 DP003862/DP/NCCDPHP CDC HHSUnited States/ ; P01 CA163233/CA/NCI NIH HHSUnited States/ ; U58 DP003875/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  124
• Issue:
  13
• Download URL:
  https://stacks.cdc.gov/view/cdc/95040/cdc_95040_DS1.pdf
• File Type:
  [PDF - 989.48 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:311516a782c11ba1b115c1bc3acf9cfc54383542c1e9cdb225b6c680aee9faa2598c97391122ebb545cee3268effb1bdcc14114a0d9ba62bc1171a709686b74f