scholarly journals Delays in Care Associated With Non–English-Speaking Patients With Breast Cancer

2021 ◽  
Author(s):  
Katy E. Balazy ◽  
Cecil M. Benitez ◽  
Paulina M. Gutkin ◽  
Clare E. Jacobson ◽  
Rie von Eyben ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Treatment Modalities ◽  
Breast Cancer Care ◽  
Radiographic Findings ◽  
Total Care ◽  
English Speaking ◽  
Race Ethnicity ◽  
The Impact ◽  
Care Path

Background: Breast cancer care requires coordination between multiple diagnostic and treatment modalities. Disparities such as age, race/ethnicity, and socioeconomic status are associated with delays in care. This study investigates whether primary language is associated with delays in breast cancer diagnosis and treatment before and through radiotherapy (RT). Patients and Methods: This study was an institutional retrospective matched-cohort analysis of women treated with breast RT over 2 years. A total of 65 non–English-speaking (NES) patients were matched with 195 English-speaking (ES) patients according to stage, age, and chemotherapy delivery. Key time intervals along the breast cancer care path from initial findings through RT were recorded. Data were analyzed in a mixed model with matching as the random effect. The impact of race and insurance status was analyzed in addition to language. Results: Significant delays were found for NES patients, which varied by race. NES Latina patients experienced the longest delay, with a mean total care-path time of 13.53 months (from initial findings to end of RT) versus 8.18 months for all ES patients (P<.0001). Specifically, their mean total care-path time was 5.97 months longer than that of ES Latina patients (P=.001) and 5.80 months longer than that of ES White patients (P<.0001). In addition, NES Latina patients had a significantly longer total care-path time than NES patients of other races/ethnicities (P=.001). Delays were specifically seen between initial clinical or radiographic findings and diagnostic mammogram (P=.001) and between biopsy and resection (P=.044). Beyond language, race/ethnicity was itself associated with delays between resection and start of RT (P=.032) and between start and end of RT (P=.022). Conclusions: Language is associated with pre-RT delays in breast cancer care, especially for NES Latina patients. Delays are most pronounced before diagnostic mammograms, but they also exist before resection and RT. Future work should target NES patients to assist their progress along the care path.

scholarly journals Assessing the Impact of the COVID-19 Outbreak on the Attitudes and Practice of Italian Oncologists Toward Breast Cancer Care and Related Research Activities

2020 ◽  
Vol 16 (11) ◽  
pp. e1304-e1314 ◽  
Author(s):  
Francesca Poggio ◽  
Marco Tagliamento ◽  
Massimo Di Maio ◽  
Valentino Martelli ◽  
Andrea De Maria ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Weekly Paclitaxel ◽  
Breast Cancer Care ◽  
Related Research ◽  
Research Activities ◽  
Monitoring Therapy ◽  
Medical Oncologists ◽  
Metastatic Setting ◽  
The Impact

PURPOSE: To investigate the impact of the COVID-19 outbreak on the attitudes and practice of Italian oncologists toward breast cancer care and related research activities. METHODS: A 29-question anonymous online survey was sent by e-mail to members of the Italian Association of Medical Oncology and the Italian Breast Cancer Study Group on April 3, 2020. Only medical oncologists (both those in training and specialists) were invited to complete the questionnaire. RESULTS: Out of 165 responding oncologists, 121 (73.3.%) worked in breast units. In the (neo)adjuvant setting, compared with before the emergency, fewer oncologists adopted weekly paclitaxel (68.5% v 93.9%) and a dose-dense schedule for anthracycline-based chemotherapy (43% v 58.8%) during the COVID-19 outbreak. In the metastatic setting, compared with before the emergency, fewer oncologists adopted first-line weekly paclitaxel for HER2-positive disease (41.8% v 53.9%) or CDK4/6 inhibitors for luminal tumors with less-aggressive characteristics (55.8% v 80.0%) during the COVID-19 outbreak. A significant change was also observed in delaying the timing for monitoring therapy with CDK4/6 inhibitors, assessing treatment response with imaging tests, and flushing central venous devices. Clinical research and scientific activities were reduced in 80.3% and 80.1% of respondents previously implicated in these activities, respectively. CONCLUSION: Medical oncologists face many challenges in providing cancer care during the COVID-19 outbreak. Although most of the changes in their attitudes and practice were reasonable responses to the current health care emergency without expected major negative impact on patient outcomes, some potentially alarming signals of undertreatment were observed.

The Impact of Patient Shifts between Hospitals on Breast Cancer Care: A population based study in The Netherlands

2018 ◽  
Vol 92 ◽  
pp. S49
Author(s):  
E. Heeg ◽  
K. Schreuder ◽  
P.E.R. Spronk ◽  
J.C. Oosterwijk ◽  
S. Siesling ◽  
...  
Keyword(s):  
Breast Cancer ◽  
The Netherlands ◽  
Cancer Care ◽  
Population Based ◽  
Breast Cancer Care ◽  
Population Based Study ◽  
The Impact

Using a disease pathway management approach to improve the quality of breast cancer care in Ontario.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 109-109
Author(s):  
Andrea Eisen ◽  
Jasmin Soobrian ◽  
Ashley Tyrrell ◽  
Clement Li ◽  
Derek Muradali ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
Performance Measurement ◽  
Quality Indicators ◽  
Cancer Care ◽  
Evidence Based ◽  
Breast Cancer Care ◽  
Patient Journey ◽  
The Impact

109 Background: Disease Pathway Management (DPM) is used by Cancer Care Ontario (CCO) to set priorities for cancer control, plan cancer services, and improve the quality of care in Ontario by promoting standardization. The DPM approach applies a framework to examine the performance of the entire system from prevention to end of life care, and to identify any gaps within the system. In 2014, DPM began its breast cancer pathway initiative by mapping the patient journey, depicting evidence-based best practice along the breast cancer care continuum, identifying where further guidance is needed for clinical decision making, and identifying gaps in quality of care and performance measurement indicators. Objective: To evaluate the impact of DPM on quality assessment of breast cancer care in Ontario. Methods: DPM convened a multidisciplinary breast cancer working group (WG) of 40 experts from across Ontario. The WG held 12 meetings and used guidelines developed by CCO’s Program in Evidence Based Care (or other sources as needed) to generate pathways for the prevention, screening and diagnosis, treatment, and follow-up care for breast cancer. The pathways were used as a framework to review the existing inventory of provincial breast cancer quality indicators, and to identify areas where evidence based guidance is needed. The pathways were subjected to an extensive review process before publication. Results: The expert WG identified 28 priority areas, including opportunities to develop guidance in areas where it is lacking (e.g. role of perioperative breast MRI; indications for contralateral prophylactic mastectomy) and system barriers that may hinder optimal care (e.g. biomarker assessment). The WG also used the pathways as a framework for evaluating performance measurement indicators by mapping 48 existing quality indicators for breast cancer to the pathway. Conclusions: The CCO DPM Breast Cancer pathways facilitated a province-wide, multidisciplinary process to promote quality standards, to identify gaps and overlaps in performance and quality measurement, and to recommend additional indicators more relevant to the quality of breast cancer care in Ontario.

scholarly journals Research-Tested Mobile Apps for Breast Cancer Care: Systematic Review (Preprint)

2018 ◽  
Author(s):  
Chiara Jongerius ◽  
Selena Russo ◽  
Ketti Mazzocco ◽  
Gabriella Pravettoni
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Cancer Prevention ◽  
Cancer Care ◽  
Care Management ◽  
Breast Cancer Prevention ◽  
Breast Cancer Care ◽  
Prevention And Early Detection ◽  
The Impact ◽  
Mhealth Apps

BACKGROUND The use of mobile health (mHealth) apps in clinical settings is increasing widely. mHealth has been used to promote prevention, improve early detection, manage care, and support survivors and chronic patients. However, data on the efficacy and utility of mHealth apps are limited. OBJECTIVE The main objective of this review was to provide an overview of the available research-tested interventions using mHealth apps and their impact on breast cancer care. METHODS A systematic search of Medline, PsycINFO, Embase, and Scopus was performed to identify relevant studies. From the selected studies, the following information was extracted: authors, publication date, study objectives, study population, study design, interventions’ features, outcome measures, and results. RESULTS We identified 29 empirical studies that described a health care intervention using an mHealth app in breast cancer care. Of these, 7 studies were about the use of an mHealth application in an intervention for breast cancer prevention and early detection, 12 targeted care management, and 10 focused on breast cancer survivors. CONCLUSIONS Our results indicate consistent and promising findings of interventions using mHealth apps that target care management in breast cancer. Among the categories of mHealth apps focusing on survivorship, mHealth-based interventions showed a positive effect by promoting weight loss, improving the quality of life, and decreasing stress. There is conflicting and less conclusive data on the effect of mHealth apps on psychological dimensions. We advocate further investigation to confirm and strengthen these findings. No consistent evidence for the impact of interventions using mHealth apps in breast cancer prevention and early detection was identified due to the limited number of studies identified by our search. Future research should continue to explore the impact of mHealth apps on breast cancer care to build on these initial recommendations.

scholarly journals Access to Breast Cancer Care in Jos, North Central

2020 ◽  
pp. 1-7
Author(s):  
Alexander Femi Ale ◽  
Mercy Wakili Isichei ◽  
Michael Ayedima Misauno
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Cancer Care ◽  
Demographic Data ◽  
Descriptive Statistics ◽  
University Teaching ◽  
Treatment Modalities ◽  
Breast Cancer Care ◽  
Number Of Patients ◽  
Health Care Centers

Aims: This paper seeks to evaluate the extent to which breast cancer patients from two tertiary health care centers in Jos were able to access the different components of breast cancer care. Background: Breast cancer in low- and middle-income countries is associated with poor outcomes when compared with high-income countries. Numerous studies have identified factors responsible for this, one of them being a lack of access to the various components of breast cancer care. Breast cancer care requires a multimodal approach involving prevention, early detection, diagnosis and treatment, rehabilitation and palliative care. Access to the various modalities of care is key to a good outcome. Study Design: This study is a retrospective study. Place and Duration of the Study: The study was carried out at Jos University Teaching Hospital, and FOMAS Hospital which are both tertiary health care centers located in the city of Jos, Plateau State, Nigeria. The study spanned January 2016 to June 2019.We applied descriptive statistics for data analysis. Methodology: We included all patients who were diagnosed with breast cancer between January 2016 and December 2017. Patients were followed up for a minimum of one and a half years (from January 2018 to June 2019). The project team performed a review of medical records and charts for data elements which included; sex, age, site of tumor, stage of tumor at presentation, and access to the different treatment modalities. Data was entered into a pre-designed proforma and analyzed on the SPSS 20 Chicago, Illinois. We applied descriptive statistics to the demographic data and clinical information of patients. Results: The total number of patients was 110. Forty-four (40%) patients had access to immunohistochemistry (IHC). Eighty-nine (81%) patients were eligible for chemotherapy. Twenty-one (19%) patients were not fit for chemotherapy. Ten (9%) patients received radiotherapy.  A total of 73 (66%) patients had different forms of breast surgeries. Three (3%) patients declined surgery, while 34 (31%) were not fit for surgery. Thirty-four (31%) patients were treated with hormonal therapy. Conclusion: This study examined access to the various components of breast cancer care within two tertiary health centers. It shows that in our environment, there is limited access to immunohistochemistry, chemotherapy, radiotherapy and targeted therapy.

scholarly journals The Feasibility and Performance of the Patient Navigation Programme in Improving Breast Cancer Care in Malaysia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 95s-95s
Author(s):  
M. Jaganathan ◽  
N.H. Zainal ◽  
N. Rajaram ◽  
T. Soo Hwang ◽  
M.Y. Abdul Wahab
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Patient Navigation ◽  
Poor Adherence ◽  
Adherence To Treatment ◽  
Breast Cancer Care ◽  
Middle Income ◽  
Treatment Delays ◽  
And Performance ◽  
The Impact

Background: Breast cancer is the most common cancer in Malaysia and it is anticipated that incidence will increase by 49% from 2012 to 2025. Unfortunately, survival remains poor because of late presentation and poor adherence to evidence-based medicine. Barriers to early presentation include inadequate knowledge about the disease, financial issues, negative influence of relatives and perceived poor quality of care and services in state-run hospitals. Poor adherence to treatment is also a common struggle, and is further exacerbated by the use of traditional, alternative healing methods. While patient navigation (PN) programs have been shown to improve breast cancer outcomes in the US, its implementation and performance in low and middle income countries is not well studied. Aim: We sought to determine the impact of a PN program in reducing treatment delays and improving adherence to treatment and patient satisfaction, as well as to evaluate the barriers faced by women seeking breast cancer care in Malaysia. Methods: We established a nurse-led patient navigation center at a secondary government hospital in Klang. This clinical team involved the surgery, pathology, radiology and nursing departments and provided patient-centered care, including patient tracking and call reminder systems, family counseling, health education and decision aids. The community team involved a Patient Navigator Program Coordinator and a Community Navigator. We compared treatment delays and adherence to treatment between navigated patients and patients registered in the year prior to the PN program. We used Student t-tests and Pearson χ2 or Fisher's Exact tests to compare timeliness between navigated patients and patients registered in the year prior. Results: Of the 136 Malaysian women enrolled in the PNP in 2015, 48.9% were diagnosed with advanced disease (stage 3 or 4). Women with advance disease had a lower median monthly household income compared with women with early disease (USD $350 vs $540, P = 0.023). Women with advance disease were also less likely to have personal transportation to the hospital (36.4% vs 56.5%, P = 0.048). Compared with the year before PN, more navigated patients underwent mammography within 7 days of their first visit (96.4% vs 74.4%, P < 0.001) and received their diagnosis within 14 days of their first visit (80.0% vs 58.5%, P < 0.001). The proportion of women who met timeliness to treatment initiation was similar for navigated patients and patients in the year prior. The proportion of defaulters were marginally lesser among navigated patients compared with the year prior (4.4% vs 11.5%, P = 0.048). Conclusion: We found that integrating PN within a breast clinic of a middle income country is feasible, and in the long run, could improve outcomes for breast cancer patients. Long-term follow-up is needed to assess the impact of the PN program on improving treatment completion and survival.

Effects of COVID-19 on an academic breast oncology center in New York City.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 51-51
Author(s):  
Jake Prigoff ◽  
Grace Hillyer ◽  
Fletcher Bell ◽  
Melissa Kate Accordino
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Endocrine Therapy ◽  
Cancer Care ◽  
Management Strategies ◽  
Oncologic Outcomes ◽  
Patient Access ◽  
Breast Cancer Care ◽  
Oncology Patients ◽  
The Impact

51 Background: The influx of patients to the healthcare system due to COVID-19 impacted healthcare practices including the care of breast cancer patients. Our aim is to describe the impact this pandemic had on breast cancer care delivery at an academic center in NYC to inform policy and procedure for future crises that limit patient access to on-site facilities. Methods: A survey was sent to physicians involved in the care of patients with breast cancer at Columbia University Irving Medical Center in May 2020. Participants were asked about practice structure and changes to breast cancer care. The primary outcome was the degree that providers believed breast oncology patients’ clinical outcomes were significantly impacted by COVID-19. Secondary outcomes included changes in diagnostic and management approaches and advice for future providers faced with a similar pandemic. Results: The response rate was 65.4% (17/26). This included physicians from medical oncology (n = 7), radiology (n = 4), breast surgery (n = 3), radiation oncology (n = 2), and plastic surgery (n = 1). Seventy-six percent of physicians somewhat agreed, agreed, or strongly agreed that oncologic outcomes may be significantly impacted by the COVID-19 pandemic. Nearly half (47%) of respondents reported delays in the workup of patients due to COVID-19 with 50.0% for mammograms, 47.5% for bone scans, 46.0% for ultrasounds, 43.8% for PET scans, and 43.3% for biopsies. Eighty-two percent reported delays in overall oncologic management. Delays to systemic therapy were: intravenous/targeted therapy (37.9%), intramuscular/subcutaneous endocrine therapy (28.3%), oral chemotherapy/targeted therapy (22.9%), and oral endocrine therapy (12.8%). Delays to local therapy were: surgery (64.4%) and radiation therapy (44.6%). Almost two-thirds (64.7%) reported it necessary to use alternative oncologic management strategies. The most common piece of advice our providers offered was to increase testing capacity to all patients, especially when coming to a healthcare facility. Conclusions: The COVID-19 pandemic has caused major disruption to breast cancer practices. Breast oncology physicians reported delays in management in over 80% of patients, and the need to use alternative management strategies in over 60% of patients. Effects of these disruptions on oncologic outcomes are unknown, but over 75% of our physicians believe this will significantly impact breast oncology patients’ outcomes. There's a need for policies and procedures to structure patient care should there be a future crisis that limits patient access to oncologic care.

scholarly journals Variation in breast cancer care quality in New York and California based on race/ethnicity and Medicaid enrollment

Cancer ◽  
2015 ◽  
Vol 122 (3) ◽  
pp. 420-431 ◽  
Author(s):  
Michael J. Hassett ◽  
Maria J. Schymura ◽  
Kun Chen ◽  
Francis P. Boscoe ◽  
Foster C. Gesten ◽  
...  
Keyword(s):  
Breast Cancer ◽  
New York ◽  
Cancer Care ◽  
Care Quality ◽  
Breast Cancer Care ◽  
Medicaid Enrollment ◽  
Race Ethnicity
Sign in / Sign up

Export Citation Format

Share Document