Factors affecting radiotherapy prescribing patterns in the post-mastectomy setting

Area of Science:

• Oncology
• Radiation Oncology
• Breast Cancer Treatment

Background:

• Radiation therapy (RT) post-mastectomy improves breast cancer survival but can affect cosmetic outcomes after reconstruction.
• Inconsistent reporting of RT dose and fractionation schedules in existing literature.

Purpose of the Study:

• To determine patterns in RT prescribing practices within a provincial program for patients undergoing mastectomy and breast reconstruction.
• To analyze factors influencing RT fractionation and delivery in this patient cohort.

Main Methods:

• Retrospective analysis of 4016 patients diagnosed with stages 0-III breast cancer between 2012-2013.
• Focused on 1143 patients who underwent mastectomy, extracting demographic, tumor, and treatment data.
• Examined associations between RT fractionation, reconstruction type, patient age, and geographic factors.

Main Results:

• 37% of mastectomy patients (1143/4016) underwent breast reconstruction.
• Extended RT fractionation (>16 fractions) was significantly associated with both autologous and implant-based reconstruction.
• Hypofractionated RT was linked to older patient age and greater distance from the treatment center.

Conclusions:

• RT prescribing patterns for mastectomy patients are influenced by reconstruction intent, patient age, nodal status, and distance to treatment facilities.
• These factors are critical considerations for optimizing treatment decisions and outcomes in breast cancer care.