(P027) Increasing Use of Postlumpectomy Radiotherapy for Ductal Carcinoma In Situ of the Breast in the United States

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OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

The percentage of DCIS patients receiving postlumpectomy RT increased between 1999 and 2008. Younger patients with higher grade, medium-sized tumors, and fewer comorbidities were more likely to receive postlumpectomy RT.

Yi An, MD, Henry S. Park, MD, MPH, John M. Stahl, MD, Sue B. Evans, MD, MPH, Charles E. Rutter, MD; Yale University School of Medicine

INTRODUCTION: Breast ductal carcinoma in situ (DCIS) is a preinvasive neoplasm historically treated with mastectomy prior to the adoption of the breast conservation paradigm. Although postlumpectomy radiation therapy (RT) for DCIS reduces local recurrence risk, its role in patients with favorable-risk disease is controversial. As such, RT utilization rates for DCIS may vary. Here, we are the first to study the change in usage of postlumpectomy RT for DCIS and the factors associated with these changes on a national level.

METHODS: We identified patients diagnosed with DCIS and treated with lumpectomy between 1998 and 2011 within the National Cancer Database. Chi-square tests and multivariate logistical regression analyses were used to identify demographic, tumor, and treatment facility factors associated with increased likelihood of receiving postlumpectomy RT.

RESULTS: We identified 144,861 DCIS patients who underwent lumpectomy. Median age was 59 years, 84% of patients were white, and 39% had high-grade disease. A total of 99,639 (69%) women received postlumpectomy RT. The proportion receiving postlumpectomy RT increased from 61% in 1999 to 72% in 2008 (P < .01). Statistically significant predictors of postlumpectomy RT included younger age, higher grade, fewer comorbidities, rural residence, and increased distance from treatment center (P < .01 for all). Interestingly, medium-sized tumors and negative surgical margins were also significant predictors of postlumpectomy RT relative to patients with larger tumors and positive margins, suggesting that these higher-risk patients may undergo complete mastectomy rather than receive adjuvant radiotherapy.

CONCLUSION: The percentage of DCIS patients receiving postlumpectomy RT increased between 1999 and 2008. Younger patients with higher grade, medium-sized tumors, and fewer comorbidities were more likely to receive postlumpectomy RT.

Proceedings of the 97th Annual Meeting of the American Radium Society -americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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