BACKGROUND: Given accumulating evidence supporting postmastectomy radiotherapy (PMRT) in selected @entity1 , it is important to evaluate patterns and correlates of PMRT utilization, including communication and attitudinal factors. METHODS: The authors surveyed 2382 @entity1 diagnosed with @entity0 in 2002 and reported to the Los Angeles and Detroit Surveillance, Epidemiology, and End Results registries (n=1844, 77.4% response rate). Analyses were restricted to @entity1 with nonmetastatic @entity0 treated by mastectomy who had decided whether or not to undergo PMRT (n=396). The authors assessed rates of explanation, recommendation, and receipt of radiation by indication grouping, defined primarily by the 2001 American Society of Clinical Oncology guidelines. They evaluated correlates of PMRT receipt, including @entity5 and sociodemographic characteristics. They also explored @entity1 ' self-reported reasons for nonreceipt of PMRT. RESULTS: The adjusted proportion in each indication group reporting that a provider had explained radiation was high (77% of those in whom PMRT was indicated, 76% of those in whom medical opinion was divided, and 73% of those in whom PMRT was not indicated; P=.10). The adjusted proportions reporting recommendations for radiation (86%, 35%, and 17%, respectively) and receipt (81%, 34%, and 10%, respectively) varied significantly by indication grouping (P<.001). On multivariate analysis, @entity5 size (P<.001), lymph node status (P<.001), comorbidity (P=.02), and chemotherapy receipt (P=.003) were found to be independent significant correlates of PMRT receipt. The most common reasons cited for not pursuing PMRT were lack of physician recommendation and perceived lack of need. CONCLUSIONS: PMRT receipt is strongly correlated with clinical indication. The authors found no sociodemographic disparities in utilization. However, approximately one-fifth of @entity1 with strong indications did not receive treatment.

Postmastectomy radiotherapy for XXXX : patterns, correlates, communication, and insights into the decision process.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity0 :: ('MESH:D001943', 'Disease') :: ['invasive breast cancer', 'breast cancer']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
