Results of the 1983 patterns of care process survey for definitive breast irradiation

This report has documented the U.S.A. national averages for the results of the Process Survey for the 1983 Patterns of Care Study (PCS) for the processes of evaluation, work-up, and treatment for definitive breast irradiation. All women had been treated with definitive irradiation following breast-conserving surgery for early stage breast cancer. The data were collected from 191 patient charts which were randomly selected from five strata of radiotherapy practice to represent the U.S.A. national averages. Clinical and pathological characteristics of the primary tumor and regional lymph node status were similar to reported series as of 1983. Analysis of this Process Survey showed high compliance with the 1983 PCS standards of best current management of breast cancer. However, there was a wide variation in the technical delivery of the radiation fields and radiation doses used. There was good compliance with the use of documentation of the radiation treatments with simulation films, port films, implant films, and field descriptions. No systematic difference was seen amongst the various strata of radiotherapy practice. Although compliance with the majority of the parameters was relatively high, the small but important areas of lack of compliance with the standards of best current management document an incomplete transfer of technology to the radiation oncology community as a whole in 1983. Separate analysis for the outcome of treatment for these cases will be necessary to correlate process with outcome.