Faculty Collaboration Database

Influence of patient, physician, and hospital characteristics on the receipt of guideline-concordant care for inflammatory breast cancer. Cancer Epidemiol 2016 Feb;40:7-14

Date

11/26/2015

Pubmed ID

26605428

Pubmed Central ID

PMC4738104

DOI

10.1016/j.canep.2015.11.003

Scopus ID

2-s2.0-84960112506 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

PURPOSE: Inflammatory breast cancer (IBC) is an aggressive subtype of breast cancer for which treatments vary, so we sought to identify factors that affect the receipt of guideline-concordant care.

METHODS: Patients diagnosed with IBC in 2004 were identified from the Breast and Prostate Cancer Data Quality and Patterns of Care Study, containing information from cancer registries in seven states. Variation in guideline-concordant care for IBC, based on National Comprehensive Cancer Network (NCCN) guidelines, was assessed according to patient, physician, and hospital characteristics.

RESULTS: Of the 107 IBC patients in the study without distant metastasis at the time of diagnosis, only 25.8% received treatment concordant with guidelines. Predictors of non-concordance included patient age (≥70 years), non-white race, normal body mass index (BMI 18.5-25 kg/m(2)), patients with physicians graduating from medical school >15 years prior, and smaller hospital size (<200 beds). IBC patients survived longer if they received guideline-concordant treatment based on either 2003 (p=0.06) or 2013 (p=0.06) NCCN guidelines.

CONCLUSIONS: Targeting factors associated with receipt of care that is not guideline-concordant may reduce survival disparities in IBC patients. Prompt referral for neoadjuvant chemotherapy and post-operative radiation therapy is also crucial.

Author List

Denu RA, Hampton JM, Currey A, Anderson RT, Cress RD, Fleming ST, Lipscomb J, Sabatino SA, Wu XC, Wilson JF, Trentham-Dietz A

Authors

Adam Currey MD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin
J Frank Wilson MD Professor Emeritus in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Female
Guideline Adherence
Guidelines as Topic
Hospitals
Humans
Inflammatory Breast Neoplasms
Male
Medical Oncology
Middle Aged
Physicians