Benjamin D.?L. Li|W. A. Brown|Federico L. Ampil|Gary V. Burton|Herbert Yu|John C. McDonald
Patient Compliance Is Critical for Equivalent Clinical Outcomes for Breast Cancer Treated by Breast-Conservation Therapy
Louisiana State University Health Sciences Center Shreveport|Louisiana State University Health Sciences Center Shreveport|Louisiana State University Health Sciences Center Shreveport
determine compliance standard breastconservation therapy bct program predominantly indigent minority population patients early breast cancer stage ii served rural state institution south compare clinical outcomes group reported clinical trials examine socioeconomic factors may contributed rate compliancediseasefree survival overall survival early breast cancer treated bct versus modified radical mastectomy reported equivalent prospective randomized trials however patients enrolled clinical trials may representative patients living various diverse communities make united states authors hypothesis patients enrolled clinical trials national level may representative indigent patients rural south clinical trial results may directly applicablea retrospective review 55 women earlystage breast cancer treated 1990 1995 performed clinical data compliance treatment clinical followup recurrence rates examined statistical analysis performed include fisher exact test kaplanmeier survival analysis logrank testfull compliance defined completion entire course radiation therapy clinical followup bct program observed 36 patients fifteen 35 noncompliant patients complete radiation therapy significantly higher local failure rate observed 8 15 patients 53 local failure contrast patients either full compliance bct program deficient missed part clinical followup local failure rates 5 120 10 220 respectively age race stage cancer economic status measured availability medical insurance distance patients residence hospital education level evaluated potential predictors compliance none predicted patient compliance although trend toward higher compliance noted patients higher education level determined literacy testingcompliance bct protocol authors institution worse reported clinical trials noncompliance translated significant increase local failure rate factors examined suggest literacy may play role predicting compliance although bct discussed breast cancer patients judicious application clinical trial data institutions local population warranted