(P028) Adjuvant Radiation Therapy After Lumpectomy According to Insurance Status

Publication
Article
OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

Patients with Medicaid coverage or without insurance are more likely to not receive radiation after lumpectomy.

Norman Yeh, Arya Amini, MD, Christine Fisher, MD; University of Colorado Denver

PURPOSE: After a lumpectomy in early-stage breast cancer, adjuvant radiation therapy as a component of breast conservation is standard of care. The purpose of this study was to evaluate patterns of care for postlumpectomy radiation according to insurance status.

PATIENT ANDMETHODS: The Surveillance, Epidemiology, and End Results (SEER) database was examined for patients with breast cancer aged under 65 years and with a stage of T1N0. The database was queried from 2007 to 2011, with a total of 72,257 patients included in the analysis. Multinomial logistic regression was used to assess patient and tumor characteristics under multivariable analysis.

RESULTS: All patients had the following insurance status: non-Medicaid insurance (90%), any Medicaid (9%), and uninsured (2%). Medicaid (odds ratio [OR] = 0.77; 95% confidence interval [CI], 0.66–0.89; P < .001) and uninsured status (OR = 0.53; 95% CI, 0.40–0.71; P < .001) were more likely to not receive postlumpectomy radiation on multivariate analysis after adjusting for age, race, sex, residence (urban vs rural), marital status, percentage of county below federal poverty limit, percentage of county below ninth grade education, and estrogen receptor (ER)/progesterone receptor (PR)/human epidermal growth factor receptor type 2 (HER2) status. Additional statistically significant predictors for patients not receiving postlumpectomy radiation included African-American race (OR = 0.86), being unmarried (OR = 0.88), living in a county with a higher percentage of residents with less than a ninth grade education (OR = 0.60), and higher percent of county below the federal poverty level (OR = 0.57). Among uninsured patients, there was also a significant association with African-American race and residence in a county with a higher percentage of people below the federal poverty level.

CONCLUSION: Patients with Medicaid coverage or without insurance are more likely to not receive radiation after lumpectomy.

Proceedings of the 97th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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