Radiotherapy Use for DCIS Tied to Subsequent Mastectomy Risk

Women with DCIS in area with high RT use have higher odds of mastectomy at time of second event

breast cancer

FRIDAY, July 22, 2016 (HealthDay News) -- For women with ductal carcinoma in situ (DCIS), being in an area with more radiotherapy use is associated with increased likelihood of mastectomy at the time of a second breast event, according to research published online July 21 in JAMA Oncology.

In a retrospective analysis of population-based databases, Rinaa S. Punglia, M.D., M.P.H., from Harvard Medical School in Boston, and colleagues examined whether regional practice patterns of radiotherapy for DCIS affect mastectomy use in these patients. Data were collected for 2,679 women in the Surveillance, Epidemiology, and End Results (SEER) database and 757 women in SEER-Medicare with DCIS diagnosis.

The researchers found that residence in a health service area (HSA) characterized by greater radiotherapy use correlated with increased likelihood of receiving mastectomy rather than breast-conserving surgery at a subsequent breast event, even among women who had not received radiotherapy for DCIS. Among women residing in an HSA with the greatest versus the least radiotherapy use, the adjusted odds ratios for receiving mastectomy were 1.43 and 1.90 in SEER and SEER-Medicare databases, respectively.

"Areas with more radiotherapy use for DCIS had increased use of mastectomy at the time of a second breast event even among patients eligible for breast conservation," the authors write. "This association suggests that physician-related factors are affecting the likelihood of breast preservation."

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