ArticleBreast cancer research and treatment2020
Does persistent use of radiation in women > 70 years of age with early-stage breast cancer reflect tailored patient-centered care?
Article in Breast cancer research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
13 citing papers in PubMed, 24 citations in OpenAlex.
- Radiation De-Escalation in Older Women with Early-Stage ER+/HER2- Invasive Breast Cancer.Annals of surgical oncology · 2026Article
- Multi-level factors drive use of sentinel lymph node biopsy in older women with early-stage breast cancer.Breast cancer research and treatment · 2025Article
- De-Implementation of Low-Value Care for Women 70 Years of Age or Older with Low-Risk Breast Cancer During the COVID-19 Pandemic.Annals of surgical oncology · 2023Article
- Estimating Breast Cancer Overdiagnosis After Screening Mammography Among Older Women in the United States.Annals of internal medicine · 2023Article
- Age and Breast Reconstruction.Aesthetic plastic surgery · 2023Article
- Diversity of interpretations of the concept "patient-centered care for breast cancer patients"; a scoping review of current literature.Journal of evaluation in clinical practice · 2022Article
- Facility-Level Variation of Low-Value Breast Cancer Treatments in Older Women with Early-Stage Breast Cancer: Analysis of a Statewide Claims Registry.Annals of surgical oncology · 2022Article
- Using Tailored Messages to Target Overuse of Low-Value Breast Cancer Care in Older Women.The Journal of surgical research · 2022Article
- Sentinel Node Biopsy Should Not be Routine in Older Patients with ER-Positive HER2-Negative Breast Cancer Who Are Willing and Able to Take Hormone Therapy.Annals of surgical oncology · 2021Article
- Omitting Sentinel Lymph Node Biopsy in Elderly Patients: A Lost Opportunity?Annals of surgical oncology · 2021Article
- Trends in Breast Cancer Treatment De-Implementation in Older Patients with Hormone Receptor-Positive Breast Cancer: A Mixed Methods Study.Annals of surgical oncology · 2021Article
- Gaps in Online Breast Cancer Treatment Information for Older Women.Annals of surgical oncology · 2021Article
- Patient Perspectives on Treatment Options for Older Women With Hormone Receptor-Positive Breast Cancer: A Qualitative Study.JAMA network open · 2020Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
purposeRandomized controlled trials demonstrate that omission of radiation therapy (RT) in older women with early-stage cancer undergoing breast conserving surgery (BCS) is an "acceptable choice." Despite this, high RT rates have been reported. The objective was to evaluate the impact of patient- and system-level factors on RT rates in a contemporary cohort.
methodsThrough the National Cancer Data Base, we identified women with clinical stage I estrogen receptor-positive breast cancer who underwent BCS (n = 84,214). Multivariable logistic regression identified patient, tumor, and system-level factors associated with RT. Joinpoint regression analysis calculated trends in RT use over time stratified by age and facility-type, reporting annual percent change (APC).
resultsRT rates decreased from 2004 (77.2%) to 2015 (64.3%). The decline occurred earliest and was most pronounced in older women treated at academic facilities. At academic facilities, the APC was - 5.6 (95% CI - 8.6, - 2.4) after 2009 for women aged > 85 years, - 6.4 (95% CI - 9.0, - 3.8) after 2010 for women aged 80 - < 85 years, - 3.7 (95% CI - 5.6, - 1.9) after 2009 for women aged 75 - < 80, and - 2.4 (95% CI, - 3.1, - 1.6) after 2009 for women aged 70 - < 75. In contrast, at community facilities rates of RT declined later (2011, 2012, and 2013 for age groups 70-74, 75-79, and 80-84 years).
conclusionsRT rates for older women with early-stage breast cancer are declining with patient-level variation based on factors related to life expectancy and locoregional recurrence. Facility-level variation suggests opportunities to improve care delivery by focusing on barriers to de-implementation of routine use of RT.
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