Abstract P4-11-10: Breast cancer patients' preferences for adjuvant radiotherapy post-lumpectomy: Whole breast irradiation versus partial breast irradiation-single institutional study
Bibliographic record
Abstract
Abstract Background The standard regimen of radiotherapy following lumpectomy consists of whole breast irradiation (WBI) to the entire breast including the lumpectomy cavity and all the surrounding normal breast tissue. Recently, there has been increased interest in partial breast irradiation (PBI) as an alternative to WBI. However, the preferences of patients with early breast cancer as to what type of radiotherapy regimen post lumpectomy they would prefer and why is unclear in the literature. This study was conducted to determine whether patients with early stage breast cancer would prefer PBI or WBI and to identify important factors for patients when making their treatment decision. Methods Based on our previous study of early stage breast cancer patient information needs, the relevant literature and the ASTRO consensus statement guidelines, an educational tool and questionnaire were developed. New patients with early breast cancer who were referred for adjuvant radiotherapy at the large academic cancer center were invited to participate. Women >40 years of age with a new histological diagnosis of ductal carcinoma in-situ or invasive breast carcinoma treated with breast conserving surgery showing clear margins for non-invasive and invasive disease and negative axillary nodes were eligible. Descriptive statistics were calculated for all variables of interest. Survey question responses were compared between those preferring WBI or PBI using chi-square analyses or Fisher's exact tests. Results Ninety /126 patients who were approached about this study completed the survey, 27(30%) preferred PBI and 55(62%) preferred WBI. Four patients (4%) required more information to choose between WBIvsPBI, and 3 patients (3%) had no preferences. From patients who choose WBI,32(58%)patients preferred hypofractionated RTvs 14 (25%)conventional RTregimen,Factors rated as important by patients in making their decision included convenience [PBI=18/26(69%), WBI=36/54(67%)], financial factors [PBI=14/26(53%), WBI=21/55(38%)], radiation dose to the breast [PBI=20/26(80%), WBI=46/55(83%)], invasiveness [PBI=18/26(69%), WBI=43/53(81%),, recurrence rate [PBI=26/26(100%), WBI=55/55(100%)], survival [PBI=26/26(100%),WBI=54/55(98%)], side effects PBI 21/26 (81%) WBI 47/55(85%) effectiveness [PBI=25/26(96%),WBI=54/54(100%)], standard method of treatment [PBI=16/26(61%), WBI=52/54(96%), p=0.001] and radiation dose to surrounding organs [PBI=23/26(88%), WBI=52/54(95%)]. Conclusions Our study shows that patients with early breast cancer prefer WBI as an adjuvant treatment post lumpectomy. There is significant association between preference of treatment and importance of standard treatment. Patients preferring WBRT were more likely to consider standard treatment as more important than those preferring PBI.There was a marginally significant association between marital status and preference of radiotherapy(p=0.0773) and employment (p=0.0667).Those currently not employed were marginally more likely to prefer WBI than those currently employed. A detailed analysis of all decisional preferences between WBI and PBI will be presented at the meeting. Citation Format: Szumacher EF, McGuffin M, Presutti R, Pignol IP, Harth T, Mesci A, Feldman-Stewart D, Chow E, DiProspero L, Vesprini D, Rakovitch E, Lee J, Doherty M, Soliman H, Ackerman I, Cao X, Kiss A. Breast cancer patients' preferences for adjuvant radiotherapy post-lumpectomy: Whole breast irradiation versus partial breast irradiation-single institutional study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-11-10.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".