{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:43:27Z","timestamp":1787751807817,"version":"build-2784847793"},"reference-count":27,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100001006","name":"Breast Cancer Research Foundation","doi-asserted-by":"publisher","award":["BCRF-20-071"],"award-info":[{"award-number":["BCRF-20-071"]}],"id":[{"id":"10.13039\/100001006","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005301","name":"American College of Surgeons","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005301","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R03 HS025806"],"award-info":[{"award-number":["R03 HS025806"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinical-breast-cancer.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Breast Cancer"],"published-print":{"date-parts":[[2022,1]]},"DOI":"10.1016\/j.clbc.2021.05.016","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T13:14:44Z","timestamp":1623071684000},"page":"e8-e20","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":14,"title":["Has Hypofractionated Whole-Breast Radiation Therapy Become the Standard of Care in the United States? An Updated Report from National Cancer Database"],"prefix":"10.1016","volume":"22","author":[{"given":"Minji M.","family":"Kang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Waller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loren","family":"Saulsberry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dezheng","family":"Huo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.clbc.2021.05.016_bib0001","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1016\/S0140-6736(11)61629-2","article-title":"Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials","volume":"378","author":"Darby","year":"2011","journal-title":"Lancet"},{"key":"10.1016\/j.clbc.2021.05.016_bib0002","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/S1470-2045(06)70699-4","article-title":"Effect of radiotherapy fraction size on tumour control in patients with early-stage breast cancer after local tumour excision: long-term results of a randomised trial","volume":"7","author":"Owen","year":"2006","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0003","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1016\/S0140-6736(08)60348-7","article-title":"The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial","volume":"371","author":"Bentzen","year":"2008","journal-title":"Lancet"},{"key":"10.1016\/j.clbc.2021.05.016_bib0004","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1056\/NEJMoa0906260","article-title":"Long-term results of hypofractionated radiation therapy for breast cancer","volume":"362","author":"Whelan","year":"2010","journal-title":"N Engl J Med"},{"key":"10.1016\/j.clbc.2021.05.016_bib0005","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1016\/S1470-2045(13)70386-3","article-title":"The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials","volume":"14","author":"Haviland","year":"2013","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0006","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S1470-2045(08)70077-9","article-title":"The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial","volume":"9","author":"Bentzen","year":"2008","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0007","doi-asserted-by":"crossref","first-page":"2542","DOI":"10.1001\/jama.2014.16616","article-title":"Uptake and costs of hypofractionated vs conventional whole breast irradiation after breast conserving surgery in the United States, 2008-2013","volume":"312","author":"Bekelman","year":"2014","journal-title":"JAMA"},{"key":"10.1016\/j.clbc.2021.05.016_bib0008","doi-asserted-by":"crossref","DOI":"10.1093\/jnci\/djx068","article-title":"Cost-effectiveness analysis comparing conventional, hypofractionated, and intraoperative radiotherapy for early-stage breast cancer","volume":"109","author":"Deshmukh","year":"2017","journal-title":"J Natl Cancer Inst"},{"key":"10.1016\/j.clbc.2021.05.016_bib0009","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.ijrobp.2010.04.042","article-title":"Fractionation for whole breast irradiation: an American Society for Radiation Oncology (ASTRO) evidence-based guideline","volume":"81","author":"Smith","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.clbc.2021.05.016_bib0010","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s10549-017-4120-0","article-title":"Utilization trend and regimens of hypofractionated whole breast radiation therapy in the United States","volume":"162","author":"Hasan","year":"2017","journal-title":"Breast Cancer Res Treat"},{"key":"10.1016\/j.clbc.2021.05.016_bib0011","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.ijrobp.2014.06.038","article-title":"Adoption of hypofractionated whole-breast irradiation for early-stage breast cancer: a National Cancer Data Base analysis","volume":"90","author":"Wang","year":"2014","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.clbc.2021.05.016_bib0012","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/j.ijrobp.2014.09.032","article-title":"Adoption of hypofractionated radiation therapy for breast cancer after publication of randomized trials","volume":"90","author":"Jagsi","year":"2014","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.clbc.2021.05.016_bib0013","doi-asserted-by":"crossref","first-page":"S469","DOI":"10.21037\/tcr.2018.03.20","article-title":"Hypofractionated whole breast irradiation is cost-effective\u2014but is that enough to change practice?","volume":"7","author":"Gupta","year":"2018","journal-title":"Transl Cancer Res"},{"key":"10.1016\/j.clbc.2021.05.016_bib0014","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1093\/jnci\/94.15.1143","article-title":"Randomized trial of breast irradiation schedules after lumpectomy for women with lymph node-negative breast cancer","volume":"94","author":"Whelan","year":"2002","journal-title":"J Natl Cancer Inst"},{"key":"10.1016\/j.clbc.2021.05.016_bib0015","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.ijrobp.2012.12.015","article-title":"A population-based study of the fractionation of postlumpectomy breast radiation therapy","volume":"86","author":"Ashworth","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.clbc.2021.05.016_bib0016","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.radonc.2009.12.032","article-title":"Current technological clinical practice in breast radiotherapy; results of a survey in EORTC-Radiation Oncology Group affiliated institutions","volume":"94","author":"van der Laan","year":"2010","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0017","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1245\/s10434-019-07213-1","article-title":"Incident cases captured in the National Cancer Database compared with those in U.S. population based central cancer registries in 2012-2014","volume":"26","author":"Mallin","year":"2019","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0018","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.1200\/JCO.2012.45.2615","article-title":"Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343","volume":"31","author":"Hughes","year":"2013","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0019","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1056\/NEJMoa040587","article-title":"Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer","volume":"351","author":"Hughes","year":"2004","journal-title":"N Engl J Med"},{"key":"10.1016\/j.clbc.2021.05.016_bib0020","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/0895-4356(92)90133-8","article-title":"Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases","volume":"45","author":"Deyo","year":"1992","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0021","doi-asserted-by":"crossref","first-page":"3615","DOI":"10.1200\/JCO.20.01363","article-title":"Hypofractionated versus standard fractionated radiotherapy in patients with early breast cancer or ductal carcinoma in situ in a randomized phase III trial: the DBCG HYPO trial","volume":"38","author":"Offersen","year":"2020","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0022","doi-asserted-by":"crossref","first-page":"e576","DOI":"10.1200\/JOP.2015.007385","article-title":"Radiation oncology practice: adjusting to a new reimbursement model","volume":"12","author":"Konski","year":"2016","journal-title":"J Oncol Pract"},{"key":"10.1016\/j.clbc.2021.05.016_bib0023","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1001\/jamaoncol.2014.264","article-title":"Hypofractionated whole breast radiotherapy: adapting to the evidence","volume":"1","author":"Jagsi","year":"2015","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0024","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ijrobp.2019.07.002","article-title":"Radiation oncology APM: why us? why now?","volume":"105","author":"Kavanagh","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.clbc.2021.05.016_bib0025","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.prro.2018.01.012","article-title":"Radiation therapy for the whole breast: executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline","volume":"8","author":"Smith","year":"2018","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.clbc.2021.05.016_bib0026","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1111\/tbj.13515","article-title":"Fractionation in adjuvant radiotherapy for invasive breast cancer and ductal carcinoma in situ in Ontario, Canada from 2009 to 2015","volume":"26","author":"Chan","year":"2020","journal-title":"Breast J"},{"key":"10.1016\/j.clbc.2021.05.016_bib0027","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1245\/s10434-007-9747-3","article-title":"The National Cancer Data Base: a powerful initiative to improve cancer care in the United States","volume":"15","author":"Bilimoria","year":"2008","journal-title":"Ann Surg Oncol"}],"container-title":["Clinical Breast Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1526820921001440?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1526820921001440?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:22:52Z","timestamp":1761513772000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1526820921001440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["S1526820921001440"],"URL":"https:\/\/doi.org\/10.1016\/j.clbc.2021.05.016","relation":{},"ISSN":["1526-8209"],"issn-type":[{"value":"1526-8209","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Has Hypofractionated Whole-Breast Radiation Therapy Become the Standard of Care in the United States? An Updated Report from National Cancer Database","name":"articletitle","label":"Article Title"},{"value":"Clinical Breast Cancer","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.clbc.2021.05.016","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}