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Identifying Disparities in Timely Receipt of Radiation After Breast-Conserving Surgery

Nicole Reyes¹, Camila Ortega¹, Amanda Mendiola¹

¹Department of Surgery, Cleveland Clinic Akron General, 1 Akron General Ave, Akron, 44307, Ohio, USA, akrongeneral.org.

The Breast Journal

|February 5, 2026

Summary

Timely radiation therapy after breast-conserving surgery is crucial for breast cancer survival. This study found racial and insurance disparities in accessing radiation within the recommended 60-day window, highlighting a need for improved equitable care.

Area of Science:

Oncology
Public Health
Health Disparities

Background:

Adjuvant radiation therapy following breast-conserving surgery (BCS) is standard for Stages I-III breast cancer.
The Commission on Cancer (CoC) mandates radiation initiation within 60 days of definitive surgery for eligible patients.
Delays in radiation therapy can negatively impact patient survival outcomes.

Purpose of the Study:

To identify socioeconomic factors contributing to delays in adjuvant radiation therapy initiation after BCS.
To highlight treatment disparities at the institutional level.
To assess the impact of race and insurance status on timely radiation access.

Main Methods:

Retrospective analysis of the Breast Cancer Registry from 2011-2021.
Inclusion of women with Stages I-III breast cancer undergoing BCS, excluding those who received chemotherapy.
Stratification of patients by socioeconomic factors to determine predictors of radiation intervals exceeding 60 days.

Main Results:

Of 427 patients, 72.4% received radiation within 60 days.
White patients (74.7%) were more likely to receive timely radiation than Black patients (55.6%).
Patients with private insurance (74.9%) or Medicare (74.5%) had better adherence to the 60-day standard compared to those with Medicaid (50.0%).

Conclusions:

Significant racial and insurance-based disparities exist in accessing timely adjuvant radiation therapy post-BCS.
Insurance status is a key factor influencing adherence to recommended treatment timelines.
Improving access to timely radiation therapy is essential to reduce disparities for minority populations and enhance breast cancer survival.

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