A retrospective chart review was undertaken of all the patients treated with radiation for breast cancer following lumpectomy at the three hospitals included in the study. The Radiation Oncology Department at each of the three hospitals included is staffed by physicians from a single academic department. The hospitals have substantially different patient populations. One of the hospitals is an inner-city hospital that provides the majority of its care to black, medically indigent patients. The second is an academic referral center, and the third hospital is a community hospital with a diverse patient population. All of the patients in this retrospective review were treated with postlumpectomy radiotherapy. The patients that were reviewed were from 1993-1996.

Two-hundred-seventy patients were treated with breast conservation during this time period. Of those, 102 were black, 162 white, and six nonblack, nonwhite. The nonblack, nonwhite patients were either Asian or Hispanic. Race was determined from the dictated consultation notes as well as the face photos included in the radiation oncology charts. Forty-six of the patients were from the inner-city charity hospital, 58 from the community hospital, and 166 from the academic referral center.

The differences in the two racial groups were analyzed using the Chi-squared test. The data was analyzed on an actuarial basis to determine the local control and disease-free survival. Local control and survival were determined from review of the medical charts. Also, the data was analyzed for the significance of various prognostic factors, including race, institution at which the treatment was delivered, timing from lumpectomy to radiotherapy as well as the influence of protracted treatment time.
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The statistical analysis was performed using Excel (Microsoft) and JMP IN (SAS Institute). Excel was used to perform the Chi-squared testing. JMP IN was used to generate Kaplan-Meier survival curves and the log-rank test results were used to determine statistical significance. Multivariate analysis was performed using SAS (version 6.12).