While the investigators reported that overall only 54.8% of patients with high-risk breast cancer received postmastectomy radiation therapy, they also cited a report that 83.6% of high-risk patients treated at National Comprehensive Cancer Network (NCCN) institutions received such treatment. Benjamin Smith, MD, said that one reason for the higher postmastectomy radiotherapy rates is the amount of subspecialization at most NCCN cancer centers, including MD Anderson. “All I treat is breast cancer here. So that affords us the luxury of getting to be very good at treating one thing and to know the literature on that one disease site very well,” he said.

“I think people who come to NCCN institutions are usually seeking high quality of care. They tend to be a little bit more invested in their care than someone who may not have the resources to know the advantages of an NCCN institution,” he continued. “If a patient has managed to come here, that means she has the ability to navigate through the health-care system, get a second referral, and get into a place like MD Anderson. She has already passed through a few hoops, making it more likely that she will receive recommended treatment.” ■