According to an article recently published in the Journal of the National Cancer Institute, whether or not a woman with early breast cancer receives radiation therapy may be determined by certain characteristics of her surgeon.
Early breast cancer, or cancer that has not spread from the breast or axillary (under the arm) lymph nodes, is often treated with breast-conserving surgery (BCS). BCS involves the removal of the cancer and surrounding tissue but not the entire breast. Patients undergoing BCS are encouraged to undergo radiation therapy following surgery to destroy any cancer cells that may remain near the site of origin. Several clinical trials have established that in early breast cancer, radiation therapy following BCS improves outcomes compared with BCS alone in most patients. Not all patients who are eligible, however, undergo radiation therapy.
Researchers from New York recently conducted a clinical study to explore why patients who undergo BCS may not receive subsequent radiation therapy. This study included data from the Surveillance, Epidemiology and End Results(SEER)–Medicare database. Data was selected from women with Stages I or II breast cancer who were 65 years of age or older and were diagnosed between 1991 and 2002. Information from the American Medical Association Masterfile was also used in order to gather information regarding characteristics of surgeons who performed BCS on the patients in the study. The study included more than 29,700 women; 75% had received radiation therapy.
- Patients who were younger, had fewer co-existing medical conditions, were White, married, from an urban area, and diagnosed in a later year were more likely to receive radiation therapy
- Patients were also significantly more likely to have received radiation therapy if they were treated by physicians who were female, had a medical doctor degree (versus a doctorate of osteopathic medicine), trained in the United States, or had more than 15 patients.
The researchers concluded: “Surgeon characteristics were associated with patients’ receipt of adjuvant radiotherapy after BCS” and that “More research is warranted to confirm the associations to determine whether they reflect surgeon behavior, patient response, or physician–patient interactions.”
Patients diagnosed with early breast cancer may wish to speak with their physician regarding their individual risks and benefits of treatment with radiation therapy.
Reference: Hershman D, Buono D, McBride R, et al. Surgeon characteristics and receipt of adjuvant radiotherapy in women with breast cancer. Journal of the National Cancer Institute [early on-line publication]. accessed January 29, 2008. DOI: 10.1093/jnci/djm320.