title: Patterns of utilization of adjuvant radiotherapy and outcomes in black women after breast conservation at a large multidisciplinary cancer center.
abstract: OBJECTIVE
  Population-based studies have reported that as many of 35% of black women do not undergo radiotherapy (RT) after breast conservation surgery (BCS). The objective of the present study was to determine whether this trend persisted at a large multidisciplinary cancer center, and to identify the factors that predict for noncompliance with RT and determine the outcomes for this subset of patients.
  
  
  METHODS
  Between January 2002 and December 2007, 83 black women underwent BCS at Memorial Sloan-Kettering Cancer Center and were therefore eligible for the present study. Of the 83 women, 38 (46%) had Stage I, 38 (46%) Stage II, and 7 (8%) Stage III disease. Of the study cohort, 31 (37%) had triple hormone receptor-negative tumors. RT was recommended for 81 (98%) of the 83 patients (median dose, 60 Gy).
  
  
  RESULTS
  Of the 81 women, 12 (15%) did not receive the recommended adjuvant breast RT. Nonreceipt of chemotherapy (p = .003) and older age (p = .009) were associated with nonreceipt of RT. With a median follow-up of 70 months, the 3-year local control, locoregional control, recurrence-free survival, disease-free survival, and overall survival rate was 99% (actuarial 5-year rate, 97%), 96% (actuarial 5-year rate, 93%), 95% (actuarial 5-year rate, 92%), 92% (actuarial 5-year rate, 89%), and 95% (actuarial 5-year rate, 91%), respectively.
  
  
  CONCLUSIONS
  We found a greater rate of utilization adjuvant breast RT (85%) among black women after BCS than has been reported in recent studies, indicating that excellent outcomes are attainable for black women after BCS when care is administered in a multidisciplinary cancer center.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. edwards2@mskcc.org
authors.forename: Sophia M
authors.initials: SM
authors.lastname: Edwards-Bennett
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Jacks
authors.forename: Beryl
authors.initials: B
authors.lastname: McCormick
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Zhang
authors.forename: Michelle
authors.initials: M
authors.lastname: Azu
authors.forename: Alice
authors.initials: A
authors.lastname: Ho
authors.forename: Simon
authors.initials: S
authors.lastname: Powell
authors.forename: Carol
authors.initials: C
authors.lastname: Brown
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000208:ethnology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D009519:New York City; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data* / Q000639:trends; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data; D015996:Survival Rate; D016896:Treatment Outcome