Mastectomy or Breast-Conserving Therapy: Which Factors Influence A Patient's Decision?

Background: The choice between mastectomy and breast-conserving therapy (BCT) is a first step for patients with breast cancer who are confronting decisions about treatment.

Objective: To identify the most important determinants in treatment decision making by patients with breast cancer.

Methods: Between 2003 and 2013, a total of 5258 patients with breast cancer were recorded in Kaiser Permanente Northwest's cancer registry.

Early detection of breast cancer using a self-referral mammography process: the Kaiser Permanente Northwest 20-year history.

Objectives: Breast cancer is the most common malignancy in women in the Kaiser Permanente Northwest Region. Ninety-five percent of women later found to have breast cancer were seen an average of 5 times in the medical offices in the year preceding diagnosis. Until 1991, screening mammography depended on clinician ordering.

Early detection of colon cancer-the kaiser permanente northwest 30-year history: how do we measure success? Is it the test, the number of tests, the stage, or the percentage of screen-detected patients?

Introduction: Colorectal cancer (CRC) is the fourth most common malignancy in the Kaiser Permanente Northwest (KPNW) Region. The goals of CRC screening are early diagnosis of cancer in the preclinical state, down-staging of tumors, and increasing survival. This historical review summarizes the screening strategies since 1980 and their impact on early diagnosis, stage, and survival.

Bariatric Surgery in the KP Northwest Region: Optimizing Outcomes by Using a Multidisciplinary Program.

Although bariatric surgery can be an appropriate treatment option for extremely obese patients, uncertainty exists as to how to optimize treatment outcomes. This article describes a coordinated multidisciplinary program designed to educate and behaviorally prepare patients for bariatric surgery and to support long-term behavioral change.Key aspects of our program include adequate preoperative obesity-related assessment, including nutritional, psychosocial, and physical assessment; emphasis on preoperative behavior change; changing the inpatient surgical treatment care path to decrease the length of hospital stay; and providing long-term management by using enhanced clinical decision support that includes Intranet-based practice resources embedded in the electronic medical record.