title: Adjuvant radiation therapy for breast cancer in patients with schizophrenia.
abstract: BACKGROUND
  Schizophrenia affects approximately 1% of subjects in all populations studied thus far. We sought to evaluate how patients with schizophrenia who are later diagnosed with breast cancer fare when adjuvant radiation therapy (ART) is clinically indicated.
  
  
  METHODS
  We searched patient treatment file, the national inpatient computer database of the Department of Veterans Affairs, to identify patients with schizophrenia who subsequently developed breast cancer.
  
  
  RESULTS
  Forty patients had schizophrenia, who later developed breast cancer and were candidates for ART, according to well-established guidelines. Of the 40 patients who were considered candidates for ART, we found data about the decision to offer ART in 35; only 22 (63%) were offered ART and 5 of those 22 (23%) refused it.
  
  
  CONCLUSIONS
  Patients with schizophrenia and breast cancer often do not understand the nature of their illnesses well. They often do not comply with recommended standard therapies such as ART. Treatment strategies that rely on ART are likely to be met with noncompliance. Breast-preserving treatment plans may be impractical. Initial radical surgery without ART may be preferable.
authors.affiliation: Saint Louis University Medical Center, St. Louis, MO, USA.
authors.forename: Kashif N
authors.initials: KN
authors.lastname: Abdullah
authors.affiliation: Saint Louis University Medical Center, St. Louis, MO, USA.
authors.forename: Radhakrishna
authors.initials: R
authors.lastname: Janardhan
authors.affiliation: Saint Louis University Medical Center, St. Louis, MO, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Hwang
authors.affiliation: Saint Louis University Medical Center, St. Louis, MO, USA.
authors.forename: Campbell D
authors.initials: CD
authors.lastname: Williams
authors.affiliation: Saint Louis University Medical Center, St. Louis, MO, USA.
authors.forename: Mishel
authors.initials: M
authors.lastname: Farasatpour
authors.affiliation: Washington University Medical Center, St. Louis, MO, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Margenthaler
authors.affiliation: American Cancer Society, Atlanta, GA, USA.
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Virgo
authors.affiliation: Saint Louis University Medical Center, St. Louis, MO, USA; John Cochran Veterans Affairs Medical Center, St. Louis, MO, USA. Electronic address: frank.johnson1@va.gov.
authors.forename: Frank E
authors.initials: FE
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010349:Patient Compliance; D018714:Radiotherapy, Adjuvant; D012111:Residence Characteristics; D012559:Schizophrenia / Q000150:complications*
keywords: Adjuvant radiation therapy; Breast cancer; Outcomes; Schizophrenia