Cancer

BackgroundRadiotherapy omission after lumpectomy is a reasonable option for many older women with favorable prognosis breast cancer. We sought to evaluate patient perspectives regarding decision-making about radiotherapy (RT).MethodsWomen age 65\u201379 with stage I and II breast cancer reported to the Georgia and Los Angeles County SEER registries were surveyed (response rate=70%) regarding radiotherapy decisions, the rationale for omitting RT, decision-making values, and understanding of recurrence risk. We also surveyed their corresponding surgeons (response rate=77%). We evaluated patient characteristics associated with omission of RT using multilevel, multivariable logistic regression, accounting for patient clustering within surgeons.ResultsOf 999 patients, 135 omitted RT (14%). Older age, lower grade, and estrogen receptor-positive disease were each strongly associated with omission of RT in multivariable analyses, whereas number of comorbidities was not. Non-English speakers were more likely to omit RT (adjusted OR 5.9, 95% CI 1.4\u201324.5).ConclusionsTo some extent, decisions about radiotherapy omission are appropriately influenced by age, grade, and estrogen receptor status, but do not appear to be optimally tailored according to competing comorbidities. Many women who are candidates for radiotherapy omission overestimate their risk of recurrence.HHSN261201000140C/CA/NCI NIH HHS/United StatesHHSN261201000035C/CA/NCI NIH HHS/United StatesP30 AG024824/AG/NIA NIH HHS/United StatesHHSN261201000035I/CA/NCI NIH HHS/United StatesHHSN261201300015C/CA/NCI NIH HHS/United StatesHHSN261201000034C/CA/NCI NIH HHS/United StatesHHSN261201000015I/CA/NCI NIH HHS/United StatesU58 DP003862/DP/NCCDPHP CDC HHS/United StatesP01 CA163233/CA/NCI NIH HHS/United StatesU58 DP003875/DP/NCCDPHP CDC HHS/United States2020-10-06T00:00:00Z29669187PMC7537366846