Radiotherapy waiting times, resources and protocols for breast carcinoma: a survey of UK radiotherapy centres

2003 ◽  
Vol 3 (3) ◽  
pp. 113-121 ◽  
Author(s):  
H. Probst ◽  
M. Holmes ◽  
D. Dodwell
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Clinical Practice ◽  
Breast Carcinoma ◽  
Waiting Time ◽  
Linear Accelerator ◽  
Waiting Times ◽  
Technical Application ◽  
The Uk ◽  
Cancer Irradiation

Purpose: Radiation techniques employed for breast cancer must be efficient as well as effective in order to minimise waiting lists. Protocol restrictions, or the technical application of treatment, may influence planning and treatment times as radiographers follow departmental policies. A national survey of UK radiotherapy centres was undertaken to establish trends in waiting times for breast cancer irradiation; and to investigate relationships of waiting times with the deployment of equipment and personnel and technical procedures adopted.Method: A questionnaire was posted to the Head of Radiotherapy Services and a Clinical Oncologist with an interest in breast cancer in the radiotherapy centres in the UK. Survey questions investigated a number of issues, including the number of breast patients planned per week; protocols chosen; average treatment and planning times; levels of personnel and equipment; and the population served.Results: A total of 53 centres were contacted, of which 51 centres responded to some aspect of the survey (96%). Average waiting times for treatment fluctuated from 1 to 7 weeks and maximum waiting times of 11 weeks were reported. Variation in clinical practice was found, including procedure times and the number of radiographers employed per linear accelerator. A multiple regression analysis indicated that a combination of equipment levels, simulation times, and the number of breast contours taken best predicted the average waiting time for breast treatment.Conclusion: Waiting times reported were influenced by a combination of levels of equipment available and protocols adopted.

Have Standardised Referral Forms Reduced the Number of Inappropriate Referrals to Breast Clinic?

2012 ◽  
Vol 94 (2) ◽  
pp. 1-3 ◽  
Author(s):  
V Lefemine ◽  
G Osborn ◽  
AM Mainwaring ◽  
S Goyal
Keyword(s):  
Breast Cancer ◽  
Early Diagnosis ◽  
Waiting Time ◽  
Waiting Times ◽  
Diagnosis And Treatment ◽  
Breast Clinic ◽  
Department Of Health ◽  
National Breast ◽  
Specialist Services ◽  
The Uk

National breast referral guidelines in the UK were introduced in 1995 to create a framework for appropriate referral of patients to specialist breast clinics. In 1998, in an attempt to improve outcomes for patients with breast cancer, the Department of Health issued a circular entitled Breast Cancer Waiting Times – Achieving the Two Week Target. The aim of the two-week waiting time directive (Table 1) was to provide prompt access to specialist services for patients with suspected breast cancer to facilitate early diagnosis and treatment.

scholarly journals Survey of UK practice for management of breast cancer metastases to the neck

2012 ◽  
Vol 94 (7) ◽  
pp. 484-489 ◽  
Author(s):  
B Bisase ◽  
C Kerawala
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Head And Neck ◽  
Neck Dissection ◽  
Current Practice ◽  
Stage Iv ◽  
Evidence Base ◽  
Cervical Metastases ◽  
Stage Iv Disease ◽  
The Uk

INTRODUCTION Cervical metastases from breast carcinoma are rare and their management is controversial. Between 1987 and 2002 the American Joint Committee on Cancer (AJCC) staged patients with supraclavicular fossa nodal disease as M1 but the subsequent demonstration that patients with regional stage IV disease had better outcomes than visceral stage IV disease led to a reclassification of the former to stage IIIC in 2003. The literature remains inconsistent regarding the fate of these patients. Despite the attendant morbidity of treatment and lack of knowledge regarding long-term survival, we hypothesised that current practice varies in the UK and a unified approach does not exist. The aim of this study was therefore to determine current practice and opinion of both head and neck specialists and breast cancer clinicians in the UK. METHODS Questionnaires were disseminated to 185 head and neck surgeons, breast surgeons and their oncology counterparts. These outlined a clinical scenario of a patient with a history of T3 primary breast cancer presenting with cervical and supraclavicular nodal metastases, with opinion being sought regarding the significance of this status and the individual’s practical approach to the problem. The extent of any proposed neck dissection was also explored. RESULTS Of the 117 respondents, a noticeable variation in opinion was evident. Contrary to the current AJCC staging, 61% of clinicians felt that both level V and III metastases represented stage IV disease. There was a tendency towards aggressive surgical treatment with a third recommending comprehensive neck dissection despite a lack of evidence base. A disparity was noted between adjuvant treatments offered and the final pN stage. CONCLUSIONS This study suggests that at present there is widespread inconsistency in the management of breast carcinoma cervical metastases in the UK. There is a need to unify practice with an evidence base in order to improve informed multidisciplinary decision making and, ultimately, patient care. This study goes some way to supporting multicentre collaboration in order to achieve that aim.

scholarly journals Anal metastasis as the sentinel and isolated presentation of invasive ductal breast carcinoma

2016 ◽  
Vol 98 (5) ◽  
pp. e68-e70 ◽  
Author(s):  
C Rengifo ◽  
S Titi ◽  
J Walls
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Metastasis ◽  
Breast Cancer Metastasis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Invasive Ductal Breast Carcinoma ◽  
Ductal Breast Carcinoma ◽  
The Uk ◽  
Expanding Population

Breast cancer currently affects 1 in 8 women in the UK during their lifetime. Common sites for breast cancer metastasis include the axillary lymph nodes, bones, lung, liver, brain, soft tissue and adrenal glands. There is well documented evidence detailing breast metastasis to the gastrointestinal tract but anal metastasis is exceptionally rare. We present the case of a 78-year-old woman with an anal metastasis as the sentinel and isolated presentation of an invasive ductal breast carcinoma. As advances in the treatment of breast cancer improve, and with an ageing and expanding population, there will be an increasing number of cancer survivors, and more of these unusual presentations may be encountered in the future.

scholarly journals NTRK, RET, ROS1, and ALK Gene Fusion in HER2 Immunohistochemistry 2+ Breast Carcinoma

2021 ◽  
Author(s):  
Shafei Wu ◽  
Xiaohua Shi ◽  
Kaimi Li ◽  
Ying Jiang ◽  
Yuanyuan Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Practice ◽  
Targeted Therapy ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Triple Negative ◽  
Fusion Rate ◽  
Fusion Genes ◽  
Breast Cancer Patients ◽  
Cell Lung Carcinoma

Abstract ObjectiveHER2 immunohistochemistry (IHC) 2+ breast cancer patients need to determine the final HER2 status by fluorescence in situ hybridization (FISH) for selection of suitable treatment options. Although the HER2-positive cases can benefit from the anti-HER2 targeted therapy, it only made a small proportion of this group, so finding more targeted therapy methods is necessary. NTRK, RET, ROS1 and RET gene fusions have been fully investigated in non-small cell lung carcinoma and are subject to targeted therapy in clinical practice and trials. However, there are only few reports investigating these four fusion genes in breast cancer. Our study is designed to evaluate the four fusion genes in HER2 IHC 2+ breast cancer patients to find an alternative treatment option. MethodsOne hundred and seventy-seven tissue samples were included. IHC was employed to assess ALK and NTRK protein levels. FISH probes specific for HER2, ALK, NTRK1, NTRK2, NTRK3, ROS1 and RET were used. ResultsThe HER2-positivity rate of all HER2 IHC 2+ cases were 5.7%. The total fusion rate of the four oncogenes was 3.95% in HER2 IHC 2+ breast cancer patients. The fusion-positive patients were prone to be ER/PR/HER2 IHC triple negative (P=0.01) and were associated with poorly differentiated tumor (P=0.005). The NTRK, RET, ROS1, and ALK fusion rate was 0.56%, 1.13%, 1.13%, 1.13%, respectively. ConclusionsNRTK, RET, ROS1, and ALK fusion rearrangements were detected in triple-negative breast carcinoma patients which can provide patients with alternate treatment opportunities in clinical practice.

Treatment patterns and patient profiles for docetaxel-based adjuvant chemotherapy in early-stage breast cancer in China: A pooled analysis of four observational studies.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12017-e12017
Author(s):  
Binghe Xu ◽  
Zhimin Shao ◽  
Shui Wang ◽  
Zefei Jiang ◽  
Xichun Hu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Observational Studies ◽  
Pooled Analysis ◽  
Treatment Patterns ◽  
Operable Breast Cancer ◽  
Patient Profiles ◽  
Selection Of

e12017 Background: Adjuvant docetaxel-based chemotherapy is frequently used for operable breast cancer. This study investigated the patterns of use of docetaxel (T) in real-life clinical practice in China. Methods: This retrospective pooled analysis included female Chinese adults (≥18 years) with operable breast cancer treated with docetaxel-based adjuvant chemotherapy enrolled in the Asia-Pacific Breast Initiatives (APBI) I (2006-2008) and II (2009-2011) registries, and two Chinese observational studies; BC STATE (2011-2014) and BC Local Registry (2007-2010). Patients with metastatic disease were excluded. The primary endpoint was assessment of treatment patterns and patient profiles. Patient profiles for treatment regimen selection were investigated using regression analysis. Results: Data from 3020 patients were included. The most commonly used regimen was docetaxel/anthracycline combination (n=1421 [47.1%]; of whom 52.0% received T/epirubicin (E)/cyclophosphamide (C)), followed by docetaxel/other (n=705 [23.3%]; of whom 72.8% received TC), docetaxel/anthracycline sequential (n=447 [14.8%]; of whom 40.9% and 39.6% received 5-Fu/EC-T and EC-T), and ‘Other’ (n=447 [14.8%]; of whom 91.5% received T). Multivariate regression analysis revealed a significant association between selection of docetaxel/anthracycline combination and patient weight, menopausal status, and estrogen receptor and HER-2 status (Table). Conclusions: Data from real clinical practice show docetaxel/anthracycline combination is the most commonly used docetaxel-based adjuvant therapy for operable breast cancer in China; of which TEC is the most popular specific regimen. Several patient profile factors were significantly associated with the selection of docetaxel/anthracycline combination. [Table: see text]

scholarly journals Waiting Time between Breast Cancer Diagnosis and Treatment in Brazilian Women: An Analysis of Cases from 1998 to 2012

2020 ◽  
Vol 17 (11) ◽  
pp. 4030
Author(s):  
Naidhia Alves Soares Ferreira ◽  
Jean Henri Maselli Schoueri ◽  
Isabel Cristina Esposito Sorpreso ◽  
Fernando Adami ◽  
Francisco Winter dos Santos Figueiredo
Keyword(s):  
Breast Cancer ◽  
Health Services ◽  
Waiting Time ◽  
Waiting Times ◽  
Secondary Data ◽  
Breast Cancer Diagnosis ◽  
Diagnosis And Treatment ◽  
Access To Health Services ◽  
Region Of Residence ◽  
Hospital Registry

Brazilian law requires that treatment for breast cancer begin within 60 days of diagnosis. This waiting time is an indicator of accessibility to health services. The aim of this study was to analyze which factors are associated with waiting times between diagnosis and treatment of breast cancer in women in Brazil between 1998 and 2012. Information from Brazilian women diagnosed with breast cancer between 1998 and 2012 was collected through the Hospital Registry of Cancer (HRC), developed by the National Cancer Institute (INCA). We performed a secondary data analysis, and found that the majority of women (81.3%) waited for ≤60 days to start treatment after being diagnosed. Those referred by the public health system, aged ≥50 years, of nonwhite race, diagnosed at stage I or II, and with low levels of education waited longer for treatment to start. We observed that only 18.7% experienced a delay in starting treatment, which is a positive reflection of the quality of the care network for the diagnosis and treatment of breast cancer. We also observed inequalities in access to health services related to age, region of residence, stage of the disease, race, and origin of referral to the health service.

scholarly journals Differences in Perceived Waiting Time by Health Insurance Type in the Inpatient Sector: An Analysis of Patients With Breast Cancer in Germany

2019 ◽  
Vol 56 ◽  
pp. 004695801987589 ◽  
Author(s):  
Susan Lee ◽  
Sophie E. Gross ◽  
Holger Pfaff ◽  
Antje Dresen
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Health Insurance ◽  
Waiting Time ◽  
Care Center ◽  
Waiting Times ◽  
Breast Cancer Surgery ◽  
Cross Sectional ◽  
Insurance Type ◽  
The Impact

Although the relationship between health insurance and waiting time has been established in the ambulatory sector in Germany, research in the inpatient sector is limited. This study aims to contribute to previous work through analyzing differences in perceived waiting time by health insurance type during the inpatient stays of patients with breast cancer in Germany. This study utilizes cross-sectional data from 2017 of patients with breast cancer (N = 4626) who underwent primary breast cancer surgery in a certified breast care center in Germany. Results from multilevel logistic regression models indicate a significant effect of health insurance status on perceived waiting time, net of other relevant factors (patient’s sociodemographic background, Union for International Cancer Control stage, grading, self-reported and classified health, type of surgery, and chemotherapy). Patients with statutory insurance were significantly more likely than privately insured patients to report long waiting times for examinations/procedures, discharge, and to speak with the physician. There were no significant differences in waiting time for nursing staff between private and statutory insurance holders. Results align with previous findings in the ambulatory sector and suggest a private health insurance advantage, with private patients receiving priority to some health care services. Disparities in health care accessibility and quality need to continue to be addressed and discussed, as well as the impact of health insurance type on other indicators of health.

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