Evidence map›Paper›PMID 40119190›Full record

ArticleAnnals of surgical oncology2025

Disparities in Refusal of Adjuvant Radiation for Breast-Conserving Therapy in the USA.

Rishabh Bhadouriya, Rohit V Mantena, Joshua P Selvakumar, Prerit Yadav, Tej A Patel, Bhav Jain, Alessandro Hammond, Kaitlyn Lapen, Chiara Corti, Patricia Mae G Santos and 2 more

Abstract read
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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Rishabh BhadouriyaSchool of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Rohit V MantenaSchool of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Joshua P SelvakumarSchool of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Prerit YadavThe Pennsylvania State University, University Park, PA, USA.
Tej A PatelUniversity of Pennsylvania, Philadelphia, PA, USA.
Bhav JainSchool of Medicine, Stanford University, Stanford, CA, USA.
Alessandro HammondDepartment of Biology, Harvard University, Cambridge, MA, USA.
Kaitlyn LapenDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Chiara CortiDepartment of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA.
Patricia Mae G SantosDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Urvish JainSchool of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. urj2@pitt.edu.
Edward Christopher DeeDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. deee1@mskcc.org.ORCID http://orcid.org/0000-0001-6119-0889

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundBreast-conserving therapy (BCT) with lumpectomy and adjuvant radiation offers equivalent outcomes to mastectomy among many patients with early-stage (T1-2N0) breast cancer. Nevertheless, certain populations may experience barriers to receiving BCT and may refuse radiation therapy (RT). We utilized the National Cancer Database (NCDB) to assess factors associated with refusal of adjuvant RT among patients receiving lumpectomy. PATIENTS AND

methodsWe performed a retrospective cohort analysis of women ≥ 18 years old diagnosed with cT1-2N0M0 disease in the NCDB from 2004 to 2017 who underwent lumpectomy for removal of the primary tumor. Multivariable logistic regression was used to calculate the adjusted odds ratios (ORs) of refusing RT despite physician recommendation in association with relevant sociodemographic variables. All statistical testing was two sided, and the results were deemed statistically significant at p < 0.05.

resultsOf the 580,192 women who underwent lumpectomy, 29,527 (5.09%) refused recommended RT. In the adjusted analysis, Black (OR 1.07 [95% confidence intervals (CI) 1.02-1.12], p = 0.006) and Native Hawaiian or Pacific Islander (OR 1.35 [95% CI 1.04-1.74], p = 0.025) women were more likely to refuse RT than White women. Older age, higher educational attainment, greater distance from treatment facility, uninsured status, greater comorbidity burden, and higher clinical stage were also associated with refusal of RT (all p < 0.05).

conclusionsDisparities persist in the refusal of recommended adjuvant RT among patients with early-stage breast cancer. Efforts are needed to further understand underlying reasons for treatment refusal, to promote patient education informed by cultural humility, and to reduce barriers to RT access.

Indexed as

Breast NeoplasmsHealthcare DisparitiesMastectomy, SegmentalTreatment RefusalAdultAgedFemaleFollow-Up StudiesHumansMiddle AgedPrognosisRadiotherapy, AdjuvantRetrospective StudiesUnited StatesBreast cancerBreast-conserving therapyBreast radiotherapyBreast surgeryExternal beam radiation therapyLumpectomy

Identifiers

PMID40119190

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.