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Access to multidisciplinary cancer care†
Is it linked to the use of breast-conserving surgery with radiation for early-stage breast carcinoma?
Article first published online: 16 JAN 2004
Copyright © 2004 American Cancer Society
Volume 100, Issue 4, pages 701–709, 15 February 2004
How to Cite
Baldwin, L.-M., Taplin, S. H., Friedman, H. and Moe, R. (2004), Access to multidisciplinary cancer care. Cancer, 100: 701–709. doi: 10.1002/cncr.20030
The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official Department of the Army position, policy, or decision unless so designated by other documentation. There is no implied agreement or support for the opinions in this article by the National Cancer Institute or the U.S. Government.
- Issue published online: 3 FEB 2004
- Article first published online: 16 JAN 2004
- Manuscript Accepted: 25 NOV 2003
- Manuscript Revised: 21 NOV 2003
- Manuscript Received: 5 SEP 2003
- Department of Defense Breast Cancer Research Program. Grant Number: DAMD17-98-1-8350
- breast carcinoma;
Breast-conserving surgery (BCS) with radiation (BCSR) requires a multidisciplinary care approach between surgeons and radiation oncologists.
This retrospective cohort study examined the use of preoperative radiation oncology consultation and whether use of or distance to this care was associated with treatment choice among 1188 women age ≥ 65 years who were diagnosed with local or regional breast carcinoma in Washington State in 1994 and 1995. Study outcomes included rates of BCSR; BCS alone; and mastectomy; and radiation therapy among women who underwent BCS.
Only 29% of patients in the current study consulted with a radiation oncologist preoperatively, and less than half of the patients (46.6%) consulted with either a medical oncologist or a radiation oncologist. Among women who underwent either BCSR or mastectomy, the odds of undergoing BCSR among women who had a preoperative radiation oncology consultation were 6.7 times the odds of women who did not have the consultation (P ≤ 0.001). Similarly, the odds of receiving radiation therapy among women who underwent BCS and had a preoperative radiation oncology consultation were 5 times the odds of women who did not have the consultation (P < 0.001). The 3.4% of women who lived > 50 miles from the radiation therapy center had the lowest BCSR rate (15.8%) and had the lowest radiation therapy rate among women who underwent BCS (54.5%), although these findings were not statistically significant in adjusted analyses.
A preoperative visit with a radiation oncologist was associated strongly with BCSR use. More should be done to evaluate the role of multidisciplinary consultation in the decision to use BCSR. Cancer 2004;100:701–9. © 2004 American Cancer Society.