Patient-perceived barriers to radiation therapy for breast cancer

Patient-perceived barriers to radiation therapy for breast cancer

Can J Surg 2018;61(2):141-143 | PDF

Keegan Guidolin, MD; Michael Lock, MD; Muriel Brackstone, MD, PhD


Studies have shown that a number of women do not receive adjuvant radiation therapy following breast-conserving surgery; the reasons have not been well investigated. We reviewed the charts of 267 patients in our institution who did not receive radiation therapy following surgery in order to determine patient-stated reasons for nonreceipt. We found that 43% of patients did not receive radiation because they received a completion mastectomy. Excluding these patients, reasons for nonreceipt of radiation therapy were sorted into 9 categories. Most patients declined radiation therapy (against physician advice). We identified 3 major barriers to receipt of radiation therapy: improper patient selection, transportation or ambulatory issues and patient fear surrounding radiation toxicity. All of these reasons are surmountable barriers to radiation receipt.

Accepted July 17, 2017; Published online Dec. 1, 2017

Affiliations: From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Brackstone).

Competing interests: None declared.

Contributors: All authors contributed substantially to the conception, writing, and revision of this article, and approved the final version for publication.

DOI: 10.1503/cjs.015716

Correspondence to: M. Brackstone, London Regional Cancer Program, 790 Commissioners Rd East, Office A3-931, London ON N6A 4G5,