{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:31:07Z","timestamp":1761823867239,"version":"build-2065373602"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,9,22]],"date-time":"2016-09-22T00:00:00Z","timestamp":1474502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The current study was performed to determine whether access to facilities performing accelerated partial breast irradiation (APBI) is associated with differences in the use of adjuvant radiotherapy (RT).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Using the National Cancer Data Base, the authors performed a retrospective study of women aged \u226550 years who were diagnosed with early\u2010stage breast cancer between 2004 and 2013 and treated with breast\u2010conserving surgery (BCS). Facilities performing APBI in \u226510% of their eligible patients within a given year were defined as APBI facilities whereas those not performing APBI were defined as non\u2010APBI facilities. All other facilities were excluded. The authors identified independent factors associated with RT use using multivariable logistic regression with clustering in the overall sample as well as in subsets of patients with standard\u2010risk invasive cancer, low\u2010risk invasive cancer, and ductal carcinoma in situ.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Among 222,544 patients, 76.6% underwent BCS plus RT and 23.4% underwent BCS alone. The likelihood of RT receipt in the overall sample did not appear to differ significantly between APBI and non\u2010APBI facilities (adjusted odds ratio [AOR], 1.02; <jats:italic>P<\/jats:italic>\u2009=\u2009.61). Subgroup multivariable analysis demonstrated that among patients with standard\u2010risk invasive cancer, there was no association between evaluation at an APBI facility and receipt of RT (AOR, 0.98; <jats:italic>P<\/jats:italic>\u2009=\u2009.69). However, patients with low\u2010risk invasive cancer were found to be significantly more likely to receive RT (54.4% vs 59.5%; AOR, 1.22 [<jats:italic>P<\/jats:italic>&lt;.001]), whereas patients with ductal carcinoma in situ were less likely to receive RT (56.9% vs 55.3%; AOR, 0.89 [<jats:italic>P<\/jats:italic>\u2009=\u2009.04]) at APBI facilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Patients who were eligible for observation were more likely to receive RT in APBI facilities but no difference was observed among patients with standard\u2010risk invasive cancer who would most benefit from RT. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:502\u2013511.<\/jats:bold> \u00a9 <jats:italic>2016 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30356","type":"journal-article","created":{"date-parts":[[2016,9,22]],"date-time":"2016-09-22T12:20:27Z","timestamp":1474546827000},"page":"502-511","source":"Crossref","is-referenced-by-count":2,"title":["Association between access to accelerated partial breast irradiation and use of adjuvant radiotherapy"],"prefix":"10.1002","volume":"123","author":[{"given":"Elyn H.","family":"Wang","sequence":"first","affiliation":[{"name":"Yale School of Medicine Yale University New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9366-8514","authenticated-orcid":false,"given":"Henry S.","family":"Park","sequence":"additional","affiliation":[{"name":"Yale School of Medicine Yale University New Haven Connecticut"},{"name":"Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale Yale University New Haven Connecticut"},{"name":"Department of Therapeutic Radiology Yale University New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles E.","family":"Rutter","sequence":"additional","affiliation":[{"name":"Yale School of Medicine Yale University New Haven Connecticut"},{"name":"Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale Yale University New Haven Connecticut"},{"name":"Department of Therapeutic Radiology Yale University New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cary P.","family":"Gross","sequence":"additional","affiliation":[{"name":"Yale School of Medicine Yale University New Haven Connecticut"},{"name":"Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale Yale University New Haven Connecticut"},{"name":"Department of Therapeutic Radiology Yale University New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela R.","family":"Soulos","sequence":"additional","affiliation":[{"name":"Yale School of Medicine Yale University New Haven Connecticut"},{"name":"Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale Yale University New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James B.","family":"Yu","sequence":"additional","affiliation":[{"name":"Yale School of Medicine Yale University New Haven Connecticut"},{"name":"Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale Yale University New Haven Connecticut"},{"name":"Department of Therapeutic Radiology Yale University New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne B.","family":"Evans","sequence":"additional","affiliation":[{"name":"Yale School of Medicine Yale University New Haven Connecticut"},{"name":"Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale Yale University New Haven Connecticut"},{"name":"Department of Therapeutic Radiology Yale University New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,9,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67887-7"},{"key":"e_1_2_8_3_1","unstructured":"National Comprehensive Cancer Network.Breast cancer (version 2.2016).https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/breast.pdf. 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