Adjuvant radiation therapy for breast cancer in patients with schizophrenia

Abstract Background Schizophrenia affects approximately 1% of subjects in all populations studied thus far. We sought to evaluate how patients with schizophrenia who are later diagnosed with breast cancer fare when adjuvant radiation therapy (ART) is clinically indicated. Methods We searched patient...

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Bibliographic Details
Published in:The American journal of surgery 2015-02, Vol.209 (2), p.378-384
Main Authors: Abdullah, Kashif N., M.D, Janardhan, Radhakrishna, M.B.B.S., M.S, Hwang, Mark, M.D, Williams, Campbell D., M.D, Farasatpour, Mishel, M.D, Margenthaler, Julie A., M.D, Virgo, Katherine S., Ph.D., M.B.A, Johnson, Frank E., M.D
Format: Article
Language:English
Subjects:
Adjuvant radiation therapy
Adult
Aged
Aged, 80 and over
Breast cancer
Breast Neoplasms - pathology
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Female
Humans
Medical records
Middle Aged
Neoplasm Staging
Outcomes
Patient Compliance
Radiotherapy, Adjuvant
Residence Characteristics
Schizophrenia
Schizophrenia - complications
Suicides & suicide attempts
Surgery
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Summary:Abstract Background Schizophrenia affects approximately 1% of subjects in all populations studied thus far. We sought to evaluate how patients with schizophrenia who are later diagnosed with breast cancer fare when adjuvant radiation therapy (ART) is clinically indicated. Methods We searched patient treatment file, the national inpatient computer database of the Department of Veterans Affairs, to identify patients with schizophrenia who subsequently developed breast cancer. Results Forty patients had schizophrenia, who later developed breast cancer and were candidates for ART, according to well-established guidelines. Of the 40 patients who were considered candidates for ART, we found data about the decision to offer ART in 35; only 22 (63%) were offered ART and 5 of those 22 (23%) refused it. Conclusions Patients with schizophrenia and breast cancer often do not understand the nature of their illnesses well. They often do not comply with recommended standard therapies such as ART. Treatment strategies that rely on ART are likely to be met with noncompliance. Breast-preserving treatment plans may be impractical. Initial radical surgery without ART may be preferable.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2014.07.004