Factors Associated with Breast Cancer Radiation Treatment Quality Measures: Study of a Single Institution

2019 ◽  
Vol 229 (4) ◽  
pp. e78
Author(s):  
Andrew H. Nguyen ◽  
Kelli Olsen ◽  
Arya Amini ◽  
Kimlin Tam Ashing ◽  
Lily L. Lai
Keyword(s):  
Breast Cancer ◽  
Radiation Treatment ◽  
Quality Measures ◽  
Treatment Quality ◽  
Single Institution ◽  
Factors Associated

Can protocol development improve breast cancer and breast surgery quality measures?

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 119-119
Author(s):  
Laila Samiian ◽  
Ricardo Rivera-Fernandez ◽  
Katherine Puckett ◽  
Jilma Patrick ◽  
David Chesire
Keyword(s):  
Breast Cancer ◽  
Program Development ◽  
Cancer Diagnosis ◽  
Breast Conservation ◽  
Breast Cancer Diagnosis ◽  
Quality Measures ◽  
Breast Conservation Surgery ◽  
Treatment Quality ◽  
Adjuvant Radiation ◽  
Surgical Specimen

119 Background: Since 2009, UF Health Jacksonville has made significant changes in the Breast Cancer Program. These changes spanned across multiple specialties and have focused on creating protocols, guidelines, checklists, and policies for the management of breast cancer. This study evaluated the effect of standardized institutional protocols on breast cancer quality measures. Methods: Tumor registry was used to identify 350 patients who were diagnosed and treated at UF Health Jacksonville for breast cancer from 2006-2012 (Stage 0-III excluding LCIS). A retrospective review of electronic health records was performed to compare the achievement of quality measures 2 years before program development (6/2006 – 6/2008) to that of 2 years after program development (6/2010 -6/2012). Results: There were significant improvements in breast cancer diagnosis and surgical treatment quality measures after establishment of standardized protocols. Performance of pre-surgical needle biopsies regardless of diagnostic outcome (90% vs. 96%, p=0.02), and diagnosis of carcinoma via needle biopsy (50% vs. 87%, p=0.04) both showed significant improvement. More patients underwent sentinel lymph node biopsy post-protocol (43% vs. 68%, p<0.001). There was improvement in surgical specimen orientation (58% vs. 88%, p<0.001), and image confirmation of the specimen post-protocol (86% vs. 97%, p=0.01). There was a reduction of second or additional operations (44% vs. 26%, p=0.004), which included a significant reduction in lumpectomy re-excisions for margins (30% vs. 14%, p=0.003). There was a non-significant improvement in attempted (64% vs. 71%, p=0.17), and successful breast conservation surgery (57% vs. 65%, p=0.10). There were no significant changes in the rates of recommendation for adjuvant radiation, endocrine, or chemotherapy. There was no improvement in patient adherence to the recommended adjuvant therapy based on protocol implementation. Conclusions: Implementation of standardized institutional protocols can significantly increase achievement of quality measures in breast cancer diagnosis and surgery. However, these protocols did not have a significant effect on systemic therapy or radiation therapy quality measures.

Determinan Kejadian Ca Mammae Di Poli Rawat Jalan Bedah Rsud Dr. Achmad Mochtar

2018 ◽  
Vol 3 (3) ◽  
pp. 575
Author(s):  
Neila Sulung ◽  
Rizki Yananda ◽  
Adriani Adriani
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Incidence ◽  
Hormonal Contraception ◽  
Sampling Technique ◽  
Case Control ◽  
Female Breast Cancer ◽  
Chi Square ◽  
Control Approach ◽  
Factors Associated ◽  
Cancer Breast

<p>Cancer is one of the leading causes of death worldwide. In Indonesia every year 1: 3 women per 1000 population are affected by breast cancer. Breast cancer is a cancer that attacks most women. The incidence of breast cancer is currently estimated at 39 per 100,000 population in 2008. The purpose of this study was to determine the factors associated with the risk of female breast cancer in surgical outpatient poly patients at Dr. Achmad Mochtar, Bukittinggi City. This study uses descriptive analytic method with a case control approach. The sampling technique in this study was accidental sampling. The sample in this study were all women diagnosed with breast cancer, amounting to 50 cases and 50 controls with data processing through computerization. The instrument used in this study is a questionnaire. Data analysis was performed using Chi-Square test (α = 0.05). The results showed that the factors associated with the incidence of breast cancer were genetic (p = 0.009), menarche (p = 0.014), menopause (p = 0.016), hormonal contraception (p = 0,045), obesity (p = 0,043), and high food fat (p = 0.028).  Conclusions of the study are factors related to the risk of breast cancer incidence are genetic, menarche, menopause, hormonal contraception, obesity and high-fat foods.<br /> </p><p>Penyakit kanker merupakan salah satu penyebab kematian utama di seluruh dunia. Di Indonesia setiap tahun 1:3 wanita per 1000 penduduk terserang kanker payudara. Kanker payudara merupakan kanker yang paling banyak menyerang perempuan. Angka kejadian kanker payudara saat ini diperkirakan 39 per 100.000 penduduk pada tahun 2008. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan risiko kanker payudara wanita pada pasien poli rawat jalan bedah di RSUD Dr. Achmad Mochtar Kota Bukittinggi. Penelitian ini menggunakan metode <em>deskriptif analitik</em> dengan pendekatan <em>case control</em>. Teknik pengambilan sampel dalam penelitian ini adalah <em>accidental sampling.</em> Sampel dalam penelitian ini adalah semua wanita yang terdiagnosis kanker payudara, berjumlah 50 kasus dan 50 kontrol dengan pengolahan data melalui komputerisasi. Instrument yang digunakan dalam penelitian ini adalah lembar kuisioner. Analisis data dilakukan menggunakan uji <em>Chi-Square </em>(α=0,05). Hasil penelitian menunjukkan faktor yang berhubungan dengan kejadian kanker payudara adalah genetik (p=0,009), <em>menarche</em> (p=0,014;), <em>menopause</em> (p=0,016), kontrasepsi hormonal (p=0,045), <em>obesitas </em>(p=0,043), dan makanan tinggi lemak (p=0,028). Simpulan penelitian adalah faktor yang berhubungan dengan risiko kejadian kanker payudara adalah genetik, <em>menarche, menopause,</em> kontrasepsi hormonal, <em>obesitas</em> dan makanan tinggi lemak.</p>

scholarly journals Factors Associated with “Survivor Identity” in Men with Breast Cancer

2021 ◽  
Vol 28 (3) ◽  
pp. 1696-1705
Author(s):  
Kathryn L. Dalton ◽  
Sheila N. Garland ◽  
Peggy Miller ◽  
Bret Miller ◽  
Cheri Ambrose ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Cancer Patients ◽  
Disease Type ◽  
Cancer Stage ◽  
Factors Associated ◽  
Logistic Regressions ◽  
Term Survivor ◽  
Diagnosis Age ◽  
Time Since Diagnosis

Cancer patients vary in their comfort with the label “survivor”. Here, we explore how comfortable males with breast cancer (BC) are about accepting the label cancer “survivor”. Separate univariate logistic regressions were performed to assess whether time since diagnosis, age, treatment status, and cancer stage were associated with comfort with the “survivor” label. Of the 70 males treated for BC who participated in the study, 58% moderately-to-strongly liked the term “survivor”, 26% were neutral, and 16% moderately-to-strongly disliked the term. Of the factors we explored, only a longer time since diagnosis was significantly associated with the men endorsing a survivor identity (OR = 1.02, p = 0.05). We discuss how our findings compare with literature reports on the comfort with the label “survivor” for women with BC and men with prostate cancer. Unlike males with prostate cancer, males with BC identify as “survivors” in line with women with BC. This suggests that survivor identity is more influenced by disease type and treatments received than with sex/gender identities.

scholarly journals An Exploration of Heart Failure Risk in Breast Cancer Patients Receiving Anthracyclines with or without Trastuzumab in Thailand: A Retrospective Study

2021 ◽  
Vol 11 (3) ◽  
pp. 484-493
Author(s):  
Jukapun Yoodee ◽  
Aumkhae Sookprasert ◽  
Phitjira Sanguanboonyaphong ◽  
Suthan Chanthawong ◽  
Manit Seateaw ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Breast Cancer Patients ◽  
Ventricular Ejection Fraction ◽  
Factors Associated ◽  
Palliative Intent ◽  
Increased Risk

Anthracycline-based regimens with or without anti-human epidermal growth factor receptor (HER) 2 agents such as trastuzumab are effective in breast cancer treatment. Nevertheless, heart failure (HF) has become a significant side effect of these regimens. This study aimed to investigate the incidence and factors associated with HF in breast cancer patients treated with anthracyclines with or without trastuzumab. A retrospective cohort study was performed in patients with breast cancer who were treated with anthracyclines with or without trastuzumab between 1 January 2014 and 31 December 2018. The primary outcome was the incidence of HF. The secondary outcome was the risk factors associated with HF by using the univariable and multivariable cox-proportional hazard model. A total of 475 breast cancer patients were enrolled with a median follow-up time of 2.88 years (interquartile range (IQR), 1.59–3.93). The incidence of HF was 3.2%, corresponding to an incidence rate of 11.1 per 1000 person-years. The increased risk of HF was seen in patients receiving a combination of anthracycline and trastuzumab therapy, patients treated with radiotherapy or palliative-intent chemotherapy, and baseline left ventricular ejection fraction <65%, respectively. There were no statistically significant differences in other risk factors for HF, such as age, cardiovascular comorbidities, and cumulative doxorubicin dose. In conclusion, the incidence of HF was consistently high in patients receiving combination anthracyclines trastuzumab regimens. A reduced baseline left ventricular ejection fraction, radiotherapy, and palliative-intent chemotherapy were associated with an increased risk of HF. Intensive cardiac monitoring in breast cancer patients with an increased risk of HF should be advised to prevent undesired cardiac outcomes.

Management of Recurrent or Progressing Skull Base Chondrosarcomas: Predictors of Long-Term Outcomes

2020 ◽  
Author(s):  
Jonathan D. Breshears ◽  
Franco DeMonte ◽  
Ahmed Habib ◽  
Paul W. Gidley ◽  
Shaan M. Raza
Keyword(s):  
Natural History ◽  
Skull Base ◽  
Radiation Treatment ◽  
Systemic Disease ◽  
Primary Treatment ◽  
Salvage Treatment ◽  
Low Grade ◽  
Related Factors ◽  
Factors Associated ◽  
Initial Recurrence

Abstract Background Skull base chondrosarcomas (CSA) are difficult tumors to cure and there is little data regarding salvage therapy. Objective This study aims to identify presentation and treatment-related factors which impact the progression free survival (PFS) and disease specific survival (DSS) for recurrent CSA, and to identify salvage treatment factors associated with successful restoration to the natural history following primary treatment. Methods This single-institution retrospective review included patients with recurrent/progressive CSA over a 25-year period. Survival analysis for factors impacting PFS and DSS was performed. Salvage treatment factors associated with achieving PFS ≥newly diagnosed median PFS were identified using univariate statistics. Analysis was performed on first recurrences and all recurrences combined. Results A total of 47 recurrence/progression events were analyzed from 17 patients (median two events/patient, range = 1–8). The overall PFS and DSS for the initial recurrence was 32 (range = 3–267) and 79 (range = 3–285) months, respectively. Conventional grade III or mesenchymal histology significantly predicted shorter PFS and DSS (p < 0.0001). After stratification by histology, previous radiation predicted shorter PFS for low-grade tumors (p = 0.009). Gross total resection (GTR) after a first time recurrence was significantly associated with successful salvage treatment (p < 0.05); however, this was rare. Conclusion In this series, high grade histology and prior radiation treatment negatively impacted salvage treatment outcomes, while GTR was associated with restoration to natural history following primary treatment. Careful consideration of histology, systemic disease status, previous treatments, and the anatomic extent of the skull base disease can optimize the outcomes of salvage intervention.

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