What Drives Overtreatment? Surgeon And Radiation Oncologist Views On Omission Of Adjuvant Radiotherapy For Elderly Women With Early Stage Breast Cancer.

562Background: Although trials have shown no survival advantage and only a modest improvement in local control from adjuvant radiotherapy after lumpectomy in older women with stage I, ER+ breast cancer, radiotherapy is commonly administered, raising concerns about overtreatment. Therefore, we sought to evaluate physician attitudes, knowledge, communication, and recommendations in this scenario. Methods: We mailed a survey to a national sample of 713 radiation oncologists and 879 surgeons between June to October 2015. Of these, 913 responded (57%). We assessed physicians’ attitudes, knowledge of pertinent risk information, and responses to clinical scenarios. Results: In patients age u003e = 70 with stage I, ER+ breast cancer treated with lumpectomy and endocrine therapy, omission of radiotherapy was felt to be unreasonable by 40% of surgeons and 20% of radiation oncologists (p u003c 0.001). Many surgeons (29%) and radiation oncologists (10%) erroneously associated radiotherapy in older women with improvement in s...