Utilization of Breast Conserving Therapy in Stages 0, I, and II Breast Cancer Patients in New Jersey An American College of Surgeons National Cancer Data Base (NCDB) Analysis

Background: The purpose of the study was to determine the use of breast conservation surgery (BCS) followed by whole breast irradiation [BCS + radiation therapy (RT)] in stages 0, I, and II breast cancer patients treated in New Jersey using the National Cancer Database. Materials and Methods: A retrospective analysis was conducted using the data from 13 hospitals in New Jersey certified by the American College of Surgeons Commission on Cancer and members of the Cancer Institute of New Jersey's Network affiliates. Subjects with a first primary malignancy of the breast (stages 0, I, and II) treated from 2000 to 2006 were included in the analysis. Results: A total of 11,146 patients with stage 0 (n = 2843), stage I (n = 4757), and stage II (n = 3546) were treated for their breast cancer. Of stage 0, I, and II patients, 72% (n = 2053), 73% (n = 3482), and 53% (n = 1865) received BCS, respectively. Of these patients, 40% (n = 826), 67.6% (n = 2353), and 63% (n = 1177) received adjuvant RT after BCS for their stages 0, I, and II, respectively. Use of BCS + RT was equivalent across racial groups and all ages, except patients above 70 years of age (61% <40 y, 57% 40 to 49 y, 60% 50 to 59 y, 65% 60 to 69 y, and 51% >70 y). Conclusions: These data report an underutilization of RT after BCS in patients with stage 0 breast cancer treated across 13 hospitals in New Jersey. The Commission on Cancer's Rapid Quality Reporting System may be one method of identifying groups of patients not receiving care according to evidence-based guidelines.