尽管历史研究表明，住在距离放射治疗设施较远的乳腺癌患者使用放射治疗的减少，而在一个现代全国队列中，旅行距离与乳腺癌治疗之间的关联仍然未知。通过对国家癌症数据库（2018-2020年）中有雌激素受体/孕激素受体阳性和人类表皮生长因子受体2阴性的病理分期I至II期乳腺癌女患者进行筛选，以治疗设施距离≤20英里或>20英里（第75百分位数）为切点分类。通过单变量和多变量Logistic回归及1∶1倾向匹配分析旅行距离与手术类型和治疗方案之间的关联。在包括的293,318例患者中，中位年龄为63岁，大多数患者（n=190,567，65%）距离治疗设施≤20英里。旅行负担>20英里的患者更有可能接受乳房切除术（≤20英里30.4% vs >20英里34.0%，P<.001；可能比1.14，P= .016）并较少接受放疗（≤20英里63.3% vs >20%英里60.1%，P<.001；可能比0.81，P<.001）。这些发现在倾向分数匹配后仍然存在（每组n=33,544），住得越远的患者更有可能进行乳房切除术（≤20英里30.3% vs >20英里35.3%，P<.001）并较少接受放疗（≤20英里65.4% vs >20英里58.5%，P<.001）。乳腺激素受体阳性I至II期乳腺癌患者旅行负担较大，更有可能接受乳房切除术，并较少接受放射治疗来治疗他们的疾病。Copyright © 2023 Elsevier Inc. All rights reserved.

Although historic studies of state registries have demonstrated decreased radiation therapy use for patients with breast cancer living further away from radiation facilities, the association between travel distance and breast cancer treatment in a modern national cohort remains unknown.Female patients with estrogen receptor/progesterone receptor positive and human epidermal growth factor receptor 2 negative pathologic stages I to II breast cancer were identified from the National Cancer Database (2018-2020) and dichotomized by distance ≤20 miles or >20 miles (75th percentile) from the treatment facility. The association between travel distance and type of surgery and treatment administered was analyzed by univariate and multivariate logistic regression and after 1:1 propensity matching.Of the 293,318 patients identified for inclusion, the median age was 63 years, and most patients (n = 190,567, 65%) lived ≤20 miles of the treatment facility. Patients with a travel burden >20 miles were more likely to receive a mastectomy (≤20 miles 30.4% vs >20 miles 34.0%, P < .001; odds ratio 1.14, P = .016), and less likely to receive radiation (≤20 miles 63.3% vs >20% miles 60.1%, P < .001; odds ratio 0.81, P < .001). These findings persisted after propensity score matching (n = 33,544 per cohort), with patients living further being more likely to undergo a mastectomy (≤20 miles 30.3% vs >20 miles 35.3%, P < .001) and less likely to receive radiation (≤ 20 miles 65.4% vs. >20 miles 58.5%, P < .001).Patients with hormone receptor-positive stage I to II breast cancer with a larger travel burden are more likely to receive a mastectomy and less likely to undergo radiation therapy to treat their disease.Copyright © 2023 Elsevier Inc. All rights reserved.