Diagnostics in Patients Suspect for Breast Cancer in The Netherlands

The goal of this study was to describe the variation in hospital-based diagnostic care activities for patients with symptomatology suspect for breast cancer in The Netherlands. Two cohorts were included: the ‘benign’ cohort (30,334 women suspected of, but without breast cancer) and the ‘malignant’ cohort (2236 breast cancer patients). Hospital-based financial data was combined with tumor data (malignant cohort) from The Netherlands Cancer Registry. Patterns within diagnostic pathways were analyzed. Factors influencing the number of visits and number of diagnostic care activities until diagnosis were identified in the malignant cohort with multivariable Cox and Poisson regression models. Compared to patients with benign diagnosis, patients with malignant disease received their diagnosis less frequently in one day, after an equal average number of hospital visits and higher average number of diagnostic activities. Factors increasing the number of diagnostic care activities were the following: lower age and higher cM-and cN-stages. Factors increasing the number of days until (malignant) diagnosis were as follows: higher BIRADS-score, screen-detected and higher cN-and cT-stages. Hospital of diagnosis influenced both number of activities and days to diagnosis. The diagnostic care pathway of patients with malignant disease required more time and diagnostic activities than benign disease and depends on hospital, tumor and patient characteristics.

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Long-term prognosis of young breast cancer patients (≤40 years) who did not receive adjuvant systemic treatment: protocol for the PARADIGM initiative cohort study

BMJ Open ◽

10.1136/bmjopen-2017-017842 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017842 ◽

Cited By ~ 4

Author(s):

Gwen MHE Dackus ◽

Natalie D ter Hoeve ◽

Mark Opdam ◽

Willem Vreuls ◽

Zsuzsanna Varga ◽

...

Keyword(s):

Breast Cancer ◽

The Netherlands ◽

Cancer Patients ◽

Cancer Registry ◽

Systemic Treatment ◽

Young Patients ◽

Breast Cancer Patients ◽

Adjuvant Systemic Treatment ◽

Netherlands Cancer Registry ◽

Young Breast Cancer

IntroductionCurrently used tools for breast cancer prognostication and prediction may not adequately reflect a young patient’s prognosis or likely treatment benefit because they were not adequately validated in young patients. Since breast cancers diagnosed at a young age are considered prognostically unfavourable, many treatment guidelines recommend adjuvant systemic treatment for all young patients. Patients cured by locoregional treatment alone are, therefore, overtreated. Lack of prognosticators for young breast cancer patients represents an unmet medical need and has led to the initiation of the PAtients with bReAst cancer DIaGnosed preMenopausally (PARADIGM) initiative. Our aim is to reduce overtreatment of women diagnosed with breast cancer aged≤40 years.Methods and analysisAll young, adjuvant systemic treatment naive breast cancer patients, who had no prior malignancy and were diagnosed between 1989 and 2000, were identified using the population based Netherlands Cancer Registry (n=3525). Archival tumour tissues were retrieved through linkage with the Dutch nationwide pathology registry. Tissue slides will be digitalised and placed on an online image database platform for clinicopathological revision by an international team of breast pathologists. Immunohistochemical subtype will be assessed using tissue microarrays. Tumour RNA will be isolated and subjected to next-generation sequencing. Differences in gene expression found between patients with a favourable and those with a less favourable prognosis will be used to establish a prognostic classifier, using the triple negative patients as proof of principle.Ethics and disseminationObservational data from the Netherlands Cancer Registry and left over archival patient material are used. Therefore, the Dutch law on Research Involving Human Subjects Act (WMO) is not applicable. The PARADIGM study received a ‘non-WMO’ declaration from the Medical Ethics Committee of the Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, waiving individual patient consent. All data and material used are stored in a coded way. Study results will be presented at international (breast cancer) conferences and published in peer-reviewed, open-access journals.

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Hospital Processes and the Nurse-Patient Interaction in Breast Cancer Care. Findings from a Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158224 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8224

Author(s):

Johanna Sophie Lubasch ◽

Susan Lee ◽

Christoph Kowalski ◽

Marina Beckmann ◽

Holger Pfaff ◽

...

Keyword(s):

Breast Cancer ◽

Social Support ◽

Cancer Patients ◽

Perceived Social Support ◽

Patient Characteristics ◽

Patient Survey ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Patient Interaction ◽

Hospital Structures

(1) Background: Evidence suggests that organizational processes of hospitals have an impact on patient-professional interactions. Within the nurse-patient interaction, nurses play a key role providing social support. Factors influencing the nurse-patient interaction have seldomly been researched. We aimed to examine whether the process organization in hospitals is associated with breast cancer patients’ perceived social support from nurses.; (2) Methods: Data analysis based on a cross-sectional patient survey (2979 breast cancer patients, 83 German hospitals) and information on hospital structures. Associations between process organization and perceived social support were analyzed with logistic hierarchical regression models adjusted for patient characteristics and hospital structures.; (3) Results: Most patients were 40–69 years old and classified with UICC stage II or III. Native language, age and hospital ownership status showed significant associations to the perception of social support. Patients treated in hospitals with better process organization at admission (OR 3.61; 95%-CI 1.67, 7.78) and during the hospital stay (OR 2.11; 95%-CI 1.04; 4.29) perceived significantly more social support from nurses.; (4) Conclusions: Designing a supportive nursing work environment and improving process organization in hospitals may create conditions conducive for a supportive patient-nurse interaction. More research is needed to better understand mechanisms behind the associations found.

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Socioeconomic differences in survival among breast cancer patients in the Netherlands not explained by tumor size

Breast Cancer Research and Treatment ◽

10.1007/s10549-010-1250-z ◽

2010 ◽

Vol 127 (3) ◽

pp. 721-727 ◽

Cited By ~ 14

Author(s):

E. Bastiaannet ◽

A. J. M. de Craen ◽

P. J. K. Kuppen ◽

M. J. Aarts ◽

L. G. M. van der Geest ◽

...

Keyword(s):

Breast Cancer ◽

The Netherlands ◽

Cancer Patients ◽

Tumor Size ◽

Socioeconomic Differences ◽

Breast Cancer Patients

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Quality improvement by implementing an integrated oncological care pathway for breast cancer patients

The Breast ◽

10.1016/j.breast.2014.01.008 ◽

2014 ◽

Vol 23 (4) ◽

pp. 364-370 ◽

Cited By ~ 24

Author(s):

J. van Hoeve ◽

L. de Munck ◽

R. Otter ◽

J. de Vries ◽

S. Siesling

Keyword(s):

Breast Cancer ◽

Quality Improvement ◽

Cancer Patients ◽

Care Pathway ◽

Breast Cancer Patients ◽

Oncological Care

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Integration of psycho-oncology through the whole care pathway for breast cancer patients in Europe

The Breast ◽

10.1016/j.breast.2017.03.004 ◽

2017 ◽

Vol 33 ◽

pp. 208

Author(s):

L. Neamţiu ◽

S. Deandrea ◽

L. Pylkkänen ◽

C. Freeman ◽

J. López-Alcalde ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Care Pathway ◽

Breast Cancer Patients

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Ten-year conditional recurrence risks and overall and relative survival for breast cancer patients in the Netherlands: Taking account of event-free years

European Journal of Cancer ◽

10.1016/j.ejca.2018.07.124 ◽

2018 ◽

Vol 102 ◽

pp. 82-94 ◽

Cited By ~ 6

Author(s):

Marissa C. van Maaren ◽

Luc J.A. Strobbe ◽

Marjolein L. Smidt ◽

Martine Moossdorff ◽

Philip M.P. Poortmans ◽

...

Keyword(s):

Breast Cancer ◽

The Netherlands ◽

Cancer Patients ◽

Relative Survival ◽

Breast Cancer Patients

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Abstract P6-13-03: Local Treatment Strategies in Young and Elderly Stage IV Breast Cancer Patients in the USA and The Netherlands

10.1158/0008-5472.sabcs10-p6-13-03 ◽

2010 ◽

Author(s):

W van de Water ◽

E Bastiaannet ◽

S van de Velde ◽

OM Dekkers ◽

JA Margenthaler ◽

...

Keyword(s):

Breast Cancer ◽

The Netherlands ◽

Cancer Patients ◽

Local Treatment ◽

Treatment Strategies ◽

Stage Iv ◽

Breast Cancer Patients ◽

Stage Iv Breast Cancer ◽

The Usa

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Abstract P1-08-19: 10-year conditional recurrence risks, overall and relative survival for breast cancer patients in the Netherlands: Taking account of event-free years

10.1158/1538-7445.sabcs18-p1-08-19 ◽

2019 ◽

Author(s):

MC van Maaren ◽

LJ Strobbe ◽

ML Smidt ◽

M Moossdorff ◽

PM Poortmans ◽

...

Keyword(s):

Breast Cancer ◽

The Netherlands ◽

Cancer Patients ◽

Relative Survival ◽

Breast Cancer Patients

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Breast cancer: Global quality care

10.1093/med/9780198839248.001.0001 ◽

2019 ◽

Cited By ~ 1

Keyword(s):

Breast Cancer ◽

Best Practices ◽

Cancer Care ◽

Care Pathway ◽

Health Care Systems ◽

Quality Care ◽

Breast Cancer Patients ◽

Breast Cancer Care ◽

Global Quality ◽

Care Systems

Caregivers delivering care to breast cancer patients wish to provide the highest quality breast care possible. Due to the complexity of the care pathway, this care should be delivered by a multidisciplinary team working in a breast cancer unit/centre. This book was written by experts from different disciplines and presents ideas for developing a breast unit wherever you live. The authors provide thorough descriptions of high-quality breast cancer care, define targets, methods to assess one’s care, and ideas on how to improve care within one’s resources. A global view of the quality of breast cancer care shows specific best practices applicable to many centres operating in various health care systems with different financial and political situations. Foundation hallmarks of innovation, communication, patient-centred care, multidisciplinary, and budget considerations guide specific recommendations for each component of care. This book discusses global and local considerations so that optimally ‘integrated’ breast cancer care can be organized. Each component of care (e.g. imaging, surgery, etc.) is discussed from both theoretical and practical aspects. The recommendation for each component of care is facilitated by experienced experts laying out rational and practical approaches to each step. This book provides guidance how to integrate the different disciplines into breast cancer care. Beyond treatment, it provides practical considerations regarding accreditation and certification, and it comments on the influence of budget and of treatment. Finally, it demonstrates how best practices may be altered by the emerging involvement of patients, technologies, and transitions of future societal values.

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