The use of radiation as a component of breast conservation therapy in National Comprehensive Cancer Network centers

Abstract

Purpose: Benchmark data regarding quality measures of breast cancer management are needed. We investigated rates of radiation use after breast conservation therapy (BCT) for patients treated for ductal carcinoma-in-situ (DCIS) or invasive breast cancer at National Comprehensive Cancer Network (NCCN) centers. Patients and Methods: We studied 3,333 consecutive patients treated between 1997 and 2002 with BCT for DCIS (n = 587) or for stage I or II breast cancer (n = 2,746) in eight NCCN centers. Results: The overall rate of radiation therapy use was 91 %, with a lower frequency of radiation use in DCIS versus invasive breast cancers (82 % v 94 %; odds ratio [OR] = 0.31; P < .0001). Conclusion: Radiation use as a component of BCT was high for patients seen at NCCN centers; however, there was variability in practice patterns noted across institutions. Radiation was most commonly omitted in patients with favorable disease characteristics, patients with comorbidities, and patients who also did not receive guideline-recommended systemic treatment. © 2006 by American Society of Clinical Oncology.