Breast Cancer Treatment Following Health Reform: Evidence From Massachusetts

2021 ◽  
pp. 107755872110425
Author(s):  
Lindsay M. Sabik ◽  
Kirsten Y. Eom ◽  
Bassam Dahman ◽  
Jie Li ◽  
G. J. van Londen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Health Reform ◽  
Age Groups ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Adjuvant Radiation ◽  
Difference In Differences ◽  
Using Data ◽  
The Relationship

There are well-documented differences in breast cancer treatment by insurance status. Insurance expansions provide a context to assess the relationship between insurance and patterns of breast cancer care. We examine the association of Massachusetts health reform with use of breast conserving surgery, reconstruction, and adjuvant radiation using data from the Massachusetts Cancer Registry and Surveillance Epidemiology and End Results registries for 2001-2013 and a difference-in-differences approach. We observe statistically significant increases in breast conserving surgery among nonelderly women in Massachusetts relative to trends in states and age groups not affected by health reform. We also observe relative increases in reconstruction and adjuvant radiation, though trends in these outcomes were not the same across states prior to reform, limiting our ability to draw conclusions about the relationship between reform and these outcomes. Our results suggest that health reform was associated with some improvements in breast cancer treatment.

Hazard of Recurrence among Women after Primary Breast Cancer Treatment—A 10-Year Follow-up Using Data from SEER-Medicare

2012 ◽  
Vol 21 (5) ◽  
pp. 800-809 ◽  
Author(s):  
Lee Cheng ◽  
Michael D. Swartz ◽  
Hui Zhao ◽  
Asha S. Kapadia ◽  
Dejian Lai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Primary Breast Cancer ◽  
Breast Cancer Treatment ◽  
Using Data

scholarly journals Perceived Proximity and Distance in the Doctors-Patients Relationships : Application to the Breast Cancer Treatment Case

K@iros ◽  
2019 ◽  
Author(s):  
Patrick RALET ◽  
◽  
Pascal BRASSIER ◽  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Point Of View ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Treatment Pathway ◽  
The Relationship

An obvious questioning of the doctor-patient relationship leads us to conduct a research on the point of view of patients who have had to follow a breast cancer treatment pathway. We want to know to what extent the notions of distance/proximity make it possible to explain the doctors-patients relationships, and on what realities it is based. It appears that the answer is complex, multifaceted, and rather poses the question of the dimensions of the relationship alongside the medical protocol.

Patient and surgeon correlates of shared decision making for surgical breast cancer treatment

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6031-6031
Author(s):  
S. Hawley ◽  
P. Lantz ◽  
B. Salem ◽  
A. Fagerlin ◽  
N. Janz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Surgical Treatment ◽  
Cancer Treatment ◽  
Treatment Decision ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Shared Decision ◽  
Treatment Decision Making ◽  
The Right

6031 Background: The choice of surgical breast cancer treatment represents an opportunity for shared decision making (SDM), since both mastectomy and breast conserving surgery are viable options. Yet women vary in their desire for involvement in this decision. Correlates of SDM and/or the level of involvement in breast cancer surgical treatment decision-making are not known. Methods: Breast cancer patients of Detroit and Los Angeles SEER registries were mailed a questionnaire shortly after diagnosis in 2002 (N = 1,800, RR: 77%). Their responses were merged with a surgeon survey (N = 456, RR: 80%) for a dataset of 1,547 patients of 318 surgeons. Surgical treatment decision making was categorized into: 1) surgeon-based; 2) shared; or 3) patient-based. The concordance between a woman’s self-reported actual and desired decisional involvement was categorized as having more, less, or the right amount of involvement. Decision making and concordance were each analyzed as three-level dependent variables using multinomial logistic regression controlling for clustering within surgeons. Independent variables included patient clinical, treatment and demographic factors, surgeon demographic and practice-related factors, and a measure of surgeon-patient communication. Results: 37% of women reported the surgery decision was shared, 25% that it was surgeon-based, and 38% that it was patient-based. Two-thirds experienced the right amount of involvement, while 13% had less and 19% had more. Compared to women who reported a shared decision, those with surgeon-based decision were significantly (p < 0.05) more likely to have male surgeons, and those reporting a patient-based decision were more likely to have received mastectomy vs. breast conserving surgery. Women who were less involved in the surgery decision than they wanted were younger and had less education, while those with more involvement (vs. the right amount) more often had male surgeons. Patient-surgeon communication was associated with decisional involvement. Conclusions: Correlates of SDM and decisional involvement relating to surgical breast cancer treatment differ. Determining patients’ desired role in decision making may as important as achieving a shared decision for evaluating perceived quality of care. No significant financial relationships to disclose.

scholarly journals Relationship Dynamics among Couples Dealing with Breast Cancer: A Systematic Review

2021 ◽  
Vol 18 (14) ◽  
pp. 7288
Author(s):  
Marco Valente ◽  
Ilaria Chirico ◽  
Giovanni Ottoboni ◽  
Rabih Chattat
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Web Of Science ◽  
Psychosocial Support ◽  
Breast Cancer Treatment ◽  
Sexual Life ◽  
Relationship Dynamics ◽  
Dyadic Process ◽  
The Relationship

Most studies have been concerned with the experiences and needs of women with breast cancer and spouses/partners separately. In this review, the relationship dynamics that characterize the couple’s experience of breast cancer treatment were investigated. Findings will inform both researchers and professionals in the area of oncology. A systematic literature search was performed in CINAHL, PsychINFO, MEDLINE, Scopus and Web of Science. A checklist for qualitative and observational studies was used to evaluate the methodological quality of the studies. Seventeen studies were included, and the synthesis of the literature revealed five domains that characterized the dyadic process: dyadic coping strategies, psychosocial support, communication, the couple’s sexual life and spirituality. The included studies provide the basis for knowledge and awareness about the experience of couples with cancer, the specific dimensions enacted during the breast cancer treatment path and the type of responses that are associated with a positive couple’s adjustment to the disease.

scholarly journals “Comparative study of surgical and oncologic outcomes in oncoplastic versus non- oncoplastic breast-conserving surgery for breast cancer treatment.”

JPRAS Open ◽  
2021 ◽  
Author(s):  
Natalie R. Almeida ◽  
Fabrício P. Brenelli ◽  
Cesar C. dos Santos ◽  
Renato Z. Torresan ◽  
Júlia Y. Shinzato ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Comparative Study ◽  
Cancer Treatment ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Oncologic Outcomes

scholarly journals TP8.1.4 Can volume replacement with local perforator flaps reduce the trauma to patients caused by mastectomies and cost of reconstructions in breast cancer treatment?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Georgios Karagiannidis ◽  
Caroline Mortimer ◽  
Hussein Tuffaha ◽  
Inga Peerlinck ◽  
Evangelos Mallidis
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Operating Time ◽  
Perforator Flap ◽  
Oncological Outcome ◽  
District General Hospital ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Flap Surgery ◽  
Perforator Flaps

Abstract Aims Improved screening and raised breast awareness raises the demand for breast cancer treatment. 25% - 45% of breast cancer treatment will be mastectomies, some of them followed by reconstruction. Mastectomy +/-reconstruction is a traumatic procedure which affects quality of life of patients plus extra cost for NHS for reconstruction. Can the “relative new” technique of local perforator flaps, reduce the volume of mastectomies (and subsequently reconstructions) in a District General Hospital? Methods Retrospective review of yearly breast cancer treatment operations from 2017 to 2020 in Ipswich Hospital. Results 1094 surgical operations performed for breast cancer. In 2017, 85/292 (29,1%) had mastectomy and 13/292 (4,4%) had local perforator flap surgery. In 2018, the number of mastectomies was 74/299 (24.7%), while 4/299 (1.3%) patients underwent local perforator flap surgery. In 2019, the amount of perforator flaps increased to 24/305(7.8%) while the mastectomies remained in equivalent percentages [72/305 (23.6%)]. Finally, in 2020, despite the presence of COVID19 and the decrease in surgical management of cancer, 16/198(8.5%) had local perforator flaps surgery and only 34/198 (18%) had mastectomy.0/57 (0,00%) of the local perforator flaps failed. Conclusions Local perforator flaps have resulted in 11.1% reduction in mastectomy rate (also reducing reconstructions). The exchange of mastectomy and reconstruction with breast conserving surgery and local perforator flap reduces the operating time and cost of cancer treatment without compromising oncological outcome or patient satisfaction.

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