Treatment recommendations for breast cancer should not be based on a woman's marital status

Research has shown that being single, married or divorced can influence cancer survival, but a new study shows marital status appears to have no impact on the outcome for women with breast cancer who are treated with lumpectomy and radiation.

These findings from a study conducted at Fox Chase Cancer Center were presented today at the 47th Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Denver, Colo.

"In the past, we've looked at survival rates for men and women with head and neck cancers who undergo radiotherapy," explained Shelly B. Hayes, M.D., chief resident in the radiation oncology department at Fox Chase. "What we found was that men who faired better in terms of survival were married. There didn't appear to be a link between survival and marital status for the women in this group. Likewise, in this new study involving breast cancer patient, marital status doesn't appear to affect survival." In Hayes' study, there were significant differences in age, method of detection, use of re-excision and use of systemic therapy when the group was divided by marital status.

The study population consisted of 2,143 patients with early-stage breast cancer who were treated with lumpectomy and radiation at Fox Chase Cancer Center between 1984 and 2003. Women who had a mastectomy or locally advanced disease and men with breast cancer were not eligible for this study.

The median follow-up was 76 months (a range of 12 to 265 months). The patients were divided into four groups based on their marital status: 63 percent were married, 10 percent were single, 10 percent were divorced or separated and 18 percent were widowed. "There was no statistically significant association between marital status and relapse-free survival," said Hayes. "However, age was found to be a statistically significant predictor of relapse-free survival, with women younger than age 40 versus older than 70 doing worse despite similar disease characteristics and treatment factors."

Women younger than 40 were more often single than married, while women over age 70 were more often widowed. Divorced women tended to be younger than married women. Widowed women more often had tumors detected by mammography than physical exam alone as compared to married, single or divorced women. Widowed women had fewer re-excisions than married or divorced women and more likely received no adjuvant therapy compared with married, single or divorced women.

Hayes concluded, "Treatment recommendations and follow-up for recurrence should not be altered based on a woman's marital status."