Appropriate treatment receipt after breast-conserving surgery

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Breast-conserving surgery (BCS) followed by radiation therapy (RT) is standard for early breast cancer.
• Alternative treatments like mastectomy or tamoxifen are sometimes appropriate.
• This study assessed appropriate treatment rates and factors influencing RT non-receipt after BCS.

Purpose of the Study:

• To determine the proportion of women receiving appropriate treatment after BCS.
• To identify factors associated with the non-receipt of RT post-BCS.

Main Methods:

• Retrospective cohort study utilizing linked Ontario health data (2004-2010).
• Included 33,718 patients who underwent BCS.
• Measured RT receipt, completion mastectomy rates, and patient, surgeon, and setting variables.

Main Results:

• 86.1% of all patients received RT or completion mastectomy.
• In patients <70 years, 90.8% received RT or completion mastectomy.
• Factors for non-receipt of RT in patients <70 included younger age (<46), non-academic treatment centers, and earlier treatment year.

Conclusions:

• In Ontario, 90.8% of patients <70 years receive appropriate early breast cancer treatment post-BCS.
• Younger women (<46) not receiving RT may face higher recurrence risks.
• Academic centers appear to provide more effective breast cancer care, with improvements noted over time.