Patient preferences and physician practice patterns regarding breast radiotherapy

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Multiple breast radiotherapy (RT) strategies exist, impacting patient care and autonomy.
• Alignment of physician practices with evidence and patient preferences is crucial for optimal cancer care.
• Limited data exists on patient preferences and physician practice patterns for breast RT.

Purpose of the Study:

• To assess patient preferences for different breast radiotherapy modalities.
• To evaluate current physician practice patterns in breast radiotherapy.
• To identify discrepancies between patient preferences and clinical practice.

Main Methods:

• Surveyed 5,000 randomly selected women undergoing mammography for breast RT preferences.
• Surveyed 2,150 randomly selected American Society for Radiation Oncology physician members on practice patterns.
• Analyzed preferences for hypofractionated whole breast irradiation (HF-WBI), partial breast irradiation (PBI), and conventionally fractionated whole breast irradiation (CF-WBI).

Main Results:

• Patient preferences: 62% for HF-WBI, 28% for PBI, 10% for CF-WBI.
• Physician practices: 82% use CF-WBI frequently, 56% never use HF-WBI.
• Discrepancies noted in PBI modality preferences and physician offerings; 70% of women prefer once-daily RT.

Conclusions:

• Patient-preferred HF-WBI is underutilized in clinical practice compared to PBI.
• Significant gaps exist between women's PBI modality preferences and physician offerings.
• Clinical practice patterns require better alignment with patient preferences and supporting evidence for breast RT.