Intraoperative Radiotherapy for Breast Cancer Treatment in a Rural Community

Allison W Lorenzen; Boris Kiriazov; James P De Andrade; Ingrid M Lizarraga; Carol E Scott-Conner; Sonia L Sugg; Lillian M Erdahl; Wenqing Sun; Ronald J Weigel

doi:10.1245/s10434-018-6574-7

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Intraoperative Radiotherapy for Breast Cancer Treatment in a Rural Community

Journal article

Open access

Peer reviewed

Intraoperative Radiotherapy for Breast Cancer Treatment in a Rural Community

Allison W Lorenzen, Boris Kiriazov, James P De Andrade, Ingrid M Lizarraga, Carol E Scott-Conner, Sonia L Sugg, Lillian M Erdahl, Wenqing Sun and Ronald J Weigel

Annals of surgical oncology, Vol.25(10), pp.3004-3010

10/2018

DOI: 10.1245/s10434-018-6574-7

PMCID: PMC6357224

PMID: 30030731

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https://www.ncbi.nlm.nih.gov/pmc/articles/6357224View

Open Access

Abstract

Access to health care poses particular challenges for patients living in rural communities. Intraoperative radiotherapy (IORT) offers a treatment alternative to traditional whole-breast radiation therapy (WBRT) for select patients. This study aimed to analyze the use of IORT for patients undergoing breast-conserving surgery at an academic institution located in a rural state. A retrospective review analyzed all patients at a single institution with a diagnosis of ductal carcinoma in situ (DCIS) or invasive breast cancer from April 2012 to January 2017 who were undergoing breast-conserving surgery with either IORT or WBRT. Student's t test or Fisher's exact test was used to make statistical comparisons. Patients undergoing IORT (n = 117) were significantly older than patients treated with WBRT (n = 191) (65.6 vs 58.6 years; p < 0.001) and had smaller tumors on both preoperative imaging (1.04 vs 1.66 cm; p < 0.05) and final pathology (0.99 vs 1.48 cm; p < 0.05). Patients receiving IORT lived farther from the treating facility than patients treated with WBRT (67.2 vs 30.8 miles; p < 0.05). To account for biases created in the IORT selection criteria, subgroup analysis was performed for women receiving WBRT who fulfilled IORT selection criteria, and distance traveled remained significant (67.2 vs 31.4 miles; p < 0.05). Neither recurrence nor survival differed between the IORT and WBRT groups. Medicare reimbursement for IORT was approximately 50% more than for WBRT. For women from rural communities, IORT appears to be an attractive option because these women tend to be older and to live farther from the treatment facility.

Radiotherapy

Carcinoma, Lobular - pathology

Prognosis

Follow-Up Studies

Humans

Middle Aged

Combined Modality Therapy

Neoplasm Recurrence, Local - diagnosis

Breast Neoplasms - therapy

Carcinoma, Ductal, Breast - therapy

Carcinoma, Lobular - therapy

Breast Neoplasms - pathology

Rural Population

Intraoperative Care

Carcinoma, Ductal, Breast - pathology

Female

Iowa - epidemiology

Aged

Neoplasm Recurrence, Local - epidemiology

Retrospective Studies

Mastectomy, Segmental - methods

Details

Title: Subtitle: Intraoperative Radiotherapy for Breast Cancer Treatment in a Rural Community
Creators: Allison W Lorenzen - Department of Surgery, University of Iowa, Iowa City, IA, USA
Boris Kiriazov - Department of Surgery, University of Iowa, Iowa City, IA, USA
James P De Andrade - Department of Surgery, University of Iowa, Iowa City, IA, USA
Ingrid M Lizarraga - Department of Surgery, University of Iowa, Iowa City, IA, USA
Carol E Scott-Conner - Department of Surgery, University of Iowa, Iowa City, IA, USA
Sonia L Sugg - Department of Surgery, University of Iowa, Iowa City, IA, USA
Lillian M Erdahl - Department of Surgery, University of Iowa, Iowa City, IA, USA
Wenqing Sun - Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
Ronald J Weigel - Department of Surgery, University of Iowa, Iowa City, IA, USA. Ronald-Weigel@uiowa.edu
Resource Type: Journal article
Publication Details: Annals of surgical oncology, Vol.25(10), pp.3004-3010
DOI: 10.1245/s10434-018-6574-7
PMID: 30030731
PMCID: PMC6357224
NLM abbreviation: Ann Surg Oncol
ISSN: 1068-9265
eISSN: 1534-4681
Publisher: United States
Grant note: P30 CA086862 / NCI NIH HHS T32 CA148062 / NCI NIH HHS T32CA148062 / National Cancer Institute
Language: English
Date published: 10/2018
Academic Unit: Molecular Physiology and Biophysics; Anatomy and Cell Biology; Surgery; Radiation Oncology; Biochemistry and Molecular Biology
Record Identifier: 9984047717402771

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