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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2019

01-02-2019 | Preclinical study

Treatment delays from transfers of care and their impact on breast cancer quality measures

Authors: Richard J. Bleicher, Cecilia Chang, Chihsiung E. Wang, Lori J. Goldstein, Cary S. Kaufmann, Meena S. Moran, Karen A. Pollitt, Nicholas R. Suss, David P. Winchester, Lorraine Tafra, Katharine Yao

Published in: Breast Cancer Research and Treatment | Issue 3/2019

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Abstract

Purpose

Despite delays between diagnosis and surgery adversely affecting survival, patients frequently transfer their breast cancer care between institutions. This study was performed to assess the prevalence and effect of such transfers of care (TsOC) on the time to surgery, and its impact on current time-dependent breast cancer quality metrics at Commission on Cancer (CoC) and National Accreditation Program for Breast Centers (NAPBC)-accredited institutions.

Methods

Patients having non-metastatic invasive breast cancer diagnosed between 2006 and 2015 at CoC and NAPBC centers (“reporting facilities”) in the National Cancer Database were reviewed. TsOC refer to transferring into or out of a reporting facility between diagnosis and surgery.

Results

Among 622,793 patients, 36.6% of patients transferred care. TsOC add 7.3, 7.8, 8.7, and 9.8 days in time to surgery, chemotherapy, radiotherapy, and endocrine therapy, respectively (p’s < 0.0001). On multivariable analysis, the odds of surgery occurring > 90 days from diagnosis were greatest for patients undergoing unilateral or bilateral mastectomy, Black or Hispanic patients, and those having TsOC (ORs > 1.73, p’s < 0.0001). TsOC increase the odds of non-compliance, per patient, for chemotherapy, radiotherapy and endocrine therapy time-dependent measures by 65.4%, 25.6%, and 56.5%, respectively (p < 0.0001).

Conclusions

TsOC for newly diagnosed breast cancers to or from an accredited facility result in delays in time to surgery which can affect compliance with time-dependent quality measures. Facilities frequently receiving transferred patients may be most adversely affected. Although non-compliance with these quality measures is low, institutions and accrediting bodies should be aware of these associations in order to comply with time-dependent standards.
Literature
1.
2.
3.
American College of Surgeons (2014) National Accreditation Program for Breast Centers. NAPBC Standards Manual 2014 Edition., 2014:77
4.
5.
6.
Churilla TM, Egleston BL, Murphy CT et al (2016) Patterns of multidisciplinary care in the management of non-metastatic invasive breast cancer in the United States Medicare patient. Breast Cancer Res Treat 160(1):153–162CrossRefPubMedPubMedCentral
7.
8.
9.
Polverini AC, Nelson RA, Marcinkowski E et al (2016) Time to treatment: measuring quality breast cancer care. Ann Surg Oncol 23(10):3392–3402CrossRefPubMed
10.
Ruetters D, Keinki C, Schroth S et al (2016) Is there evidence for a better health care for cancer patients after a second opinion? A systematic review. J Cancer Res Clin Oncol 142(7):1521–1528CrossRefPubMed
11.
12.
Desch CE, McNiff KK, Schneider EC et al (2008) American Society of Clinical Oncology/national comprehensive cancer network quality measures. J Clin Oncol 26(21):3631–3637CrossRefPubMed
13.
Crannell WC, Clark E, Jones C et al (2016) A pattern-matched Twitter analysis of US cancer-patient sentiments. J Surg Res 206(2):536–542CrossRefPubMed
14.
Yen TW, Pezzin LE, Li J et al (2017) Effect of hospital volume on processes of breast cancer care: a National Cancer Data Base study. Cancer 123(6):957–966CrossRefPubMed
15.
16.
Boodman SG (2016). Do you need complex surgery? Some doctors may not have much practice. Washington Post
17.
18.
Kaufman CS, Landercasper J (2011) Can we measure the quality of breast surgical care? Ann Surg Oncol 18(11):3053–3060CrossRefPubMed
19.
Tomaszewski JJ, Handorf E, Corcoran AT et al (2014) Care transitions between hospitals are associated with treatment delay for patients with muscle invasive bladder cancer. J Urol 192(5):1349–1354CrossRefPubMedPubMedCentral
20.
Recht A, Come SE, Henderson IC et al (1996) The sequencing of chemotherapy and radiation therapy after conservative surgery for early-stage breast cancer. N Engl J Med 334(21):1356–1361CrossRefPubMed
21.
Cold S, During M, Ewertz M et al (2005) Does timing of adjuvant chemotherapy influence the prognosis after early breast cancer? Results of the Danish Breast Cancer Cooperative Group (DBCG). Br J Cancer 93(6):627–632CrossRefPubMedPubMedCentral
22.
Hershman DL, Wang X, McBride R et al (2006) Delay in initiating adjuvant radiotherapy following breast conservation surgery and its impact on survival. Int J Radiat Oncol Biol Phys 65(5):1353–1360CrossRefPubMed
23.
Lohrisch C, Paltiel C, Gelmon K et al (2006) Impact on survival of time from definitive surgery to initiation of adjuvant chemotherapy for early-stage breast cancer. J Clin Oncol 24(30):4888–4894CrossRefPubMed
24.
Jara Sanchez C, Ruiz A, Martin M et al (2007) Influence of timing of initiation of adjuvant chemotherapy over survival in breast cancer: a negative outcome study by the Spanish Breast Cancer Research Group (GEICAM). Breast Cancer Res Treat 101(2):215–223CrossRefPubMed
25.
Yu KD, Huang S, Zhang JX et al (2013) Association between delayed initiation of adjuvant CMF or anthracycline-based chemotherapy and survival in breast cancer: a systematic review and meta-analysis. BMC Cancer 13:240CrossRefPubMedPubMedCentral
26.
Gagliato Dde M, Gonzalez-Angulo AM, Lei X et al (2014) Clinical impact of delaying initiation of adjuvant chemotherapy in patients with breast cancer. J Clin Oncol 32(8):735–744CrossRefPubMed
27.
Chavez-MacGregor M, Clarke CA, Lichtensztajn DY et al (2016) Delayed Initiation of adjuvant chemotherapy among patients with breast cancer. JAMA Oncol 2(3):322–329CrossRefPubMedPubMedCentral
28.
Raphael MJ, Biagi JJ, Kong W et al (2016) The relationship between time to initiation of adjuvant chemotherapy and survival in breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat 160(1):17–28CrossRefPubMed
29.
Yu KD, Fan L, Qiu LX et al (2017) Influence of delayed initiation of adjuvant chemotherapy on breast cancer survival is subtype-dependent. Oncotarget 8(28):46549–46556CrossRefPubMed
30.
Abdel-Rahman O (2018) Impact of timeliness of adjuvant chemotherapy and radiotherapy on the outcomes of breast cancer; a pooled analysis of three clinical trials. Breast 38:175–180CrossRefPubMed
31.
McGuire KP, Santillan AA, Kaur P et al (2009) Are mastectomies on the rise? A 13-year trend analysis of the selection of mastectomy versus breast conservation therapy in 5865 patients. Ann Surg Oncol 16(10):2682–2690CrossRefPubMed
32.
Balasubramanian BA, Demissie K, Crabtree BF et al (2012) Black Medicaid beneficiaries experience breast cancer treatment delays more frequently than whites. Ethn Dis 22(3):288–294PubMed
33.
Wilke LG, Czechura T, Wang C et al (2014) Repeat surgery after breast conservation for the treatment of stage 0 to II breast carcinoma: a report from the National Cancer Data Base, 2004–2010. JAMA Surg 149(12):1296–1305CrossRefPubMed
34.
Loveland-Jones C, Ruth K, Sigurdson ER et al (2012) Breast conservation in the medicare patient: will the american college of surgeons oncology group Z0011 trial change the pattern of care? Ann Surg Oncol 19s1:S64
35.
Metadata
Title
Treatment delays from transfers of care and their impact on breast cancer quality measures
Authors
Richard J. Bleicher
Cecilia Chang
Chihsiung E. Wang
Lori J. Goldstein
Cary S. Kaufmann
Meena S. Moran
Karen A. Pollitt
Nicholas R. Suss
David P. Winchester
Lorraine Tafra
Katharine Yao
Publication date
01-02-2019
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-018-5046-x

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