Demographic risk factors impacting timely radiation therapy completion after breast conserving surgery.
BACKGROUND
Radiotherapy completion (RTC) is critical to successful breast conserving treatment. Our aim was to identify patient groups at greatest risk of not achieving timely radiotherapy completion (TRTC) in an urban setting.


METHODS
This observational cohort study used hospital registry data from 2004 to 2010 for female stage I and II breast conserving treatment patients to assess predictors of RTC and TRTC, defined as RTC of 35 to 49 days.


RESULTS
Two hundred sixty-one patients were analyzed. There was no difference in mean days to RTC by ethnicity (black 46.8, white 46.4, Hispanic 48.1 days, P = .75) or total RTC (black 88.2%, white 97.9%, Hispanic 93.3%, P = .09). However, a substantial difference was seen in TRTC by ethnicity (black 51.8%, white 79.2%, Hispanic 57.8%, P = .03). Multivariate logistic regression analysis of failure to achieve TRTC found associations with black race (odds ratio [OR] 2.67), Medicare (OR 3.46), Medicaid (OR 2.19), and age less than 50 years (OR 4.13).


CONCLUSIONS
This study demonstrates high overall percentage RTC but demonstrates disparities in TRTC. Those at greatest risk of unsuccessful TRTC were younger, Medicare or Medicaid insured, and black race.
Department of Surgery, Temple University School of Medicine, Philadelphia, PA, USA.
Benjamin D
BD
Powers
Department of Surgery, Temple University School of Medicine, Philadelphia, PA, USA.
Jennifer A
JA
Montes
Department of Surgery, Temple University School of Medicine, Philadelphia, PA, USA.
Duy C
DC
Nguyen
Temple University Hospital Cancer Center, Philadelphia, PA, USA.
Donna A
DA
Nick
Department of Surgery, Temple University School of Medicine, Philadelphia, PA, USA.
Maureen P
MP
Daly
Department of Public Health, Temple University, Philadelphia, PA, USA.
Adam
A
Davey
Division of Surgical Oncology, Department of Surgery, Temple University School of Medicine, Philadelphia, PA, USA. Electronic address: Alliric.Willis@tuhs.temple.edu.
Alliric I
AI
Willis
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D015999:Multivariate Analysis; D018714:Radiotherapy, Adjuvant; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States; D001741:Black or African American
Breast cancer; Breast conserving treatment; Disparities