Fostering coordinated survivorship care in breast cancer: who is lost to follow-up?

Introduction: Increasing numbers of cancer survivors and the recognition of their needs beyond recurrence surveillance are stretching resources at many cancer centers. Sometimes, patients solely follow up with providers other than the oncologist without coordinated care transfer plans. This study examines factors associated with transfer of breast cancer survivorship care outside one large cancer center.

Completeness of American Cancer Registry Treatment Data: implications for quality of care research.

Background: Evaluating and improving the quality of cancer care requires complete information on cancer stage and treatment. Hospital-based registries are a key tool in this effort, but reports in the 1990s showed that they fail to identify a major fraction of outpatient-administered treatment, including chemotherapy, endocrine therapy, and radiation. This can limit their value for evaluating patterns and quality of care.

Impact of body mass index on clinical outcomes in triple-negative breast cancer.

Background: Obesity is associated with poorer outcomes in patients with hormone receptor-positive breast cancers. This association is not well established for women with triple-negative breast cancers (TNBC). In this study, the prognostic effects of body mass index on clinical outcome were evaluated in patients with TNBC.

Claims data linked to hospital registry data enhance evaluation of the quality of care of breast cancer.

Background: Complete treatment data is central to evaluation and improvement of cancer care quality. Cancer registries vary in completeness of radiation (RT), chemotherapy (CT), and hormone therapy (HT) data. Administrative claims from health payers may supplement these registries.

TLE3 as a candidate biomarker of response to taxane therapy.

Introduction: The addition of taxanes (Ts) to chemotherapeutic regimens has not demonstrated a consistent benefit in early-stage breast cancer. To date, no clinically relevant biomarkers that predict T response have been identified.

Methods: A dataset of immunohistochemistry stains in 411 patients was mined to identify potential markers of response.

Prognosis of occult breast carcinoma presenting as isolated axillary nodal metastasis.

Axillary metastasis from an occult breast carcinoma is an uncommon presentation and presents a therapeutic dilemma. The objective of this study is to describe the presenting clinical features, management approach and treatment outcomes for occult breast carcinoma. We conducted a retrospective review of patients who presented with axillary nodal metastases from an occult breast carcinoma between 1997 and 2004 at the Roswell Park Cancer Institute; 2,150 patients were diagnosed and treated for breast cancer during this period.

Linked claims and medical records for cancer case management : evaluation of mammography abnormalities.

Background: Failure to obtain the requisite follow-up of patients with abnormal mammograms may delay cancer diagnosis and impact outcome. Up to 20% of women do not receive timely recommended follow-up. The current study tested the accuracy of the linkage of payer claims and clinical data to identify the appropriate treatment for patients with abnormal mammograms.

Axillary recurrence in women with a negative sentinel lymph node and no axillary dissection in breast cancer.

Objectives: Sentinel lymph node biopsy (SLNB) is widely used for staging breast cancer. SLNB accurately determines axillary lymph node status with a low false negative rate. There remains concern that omitting axillary dissection may lead to recurrence in the axilla, and impact long term survival.

Lymphedema secondary to postmastectomy radiation: incidence and risk factors.

Background: Postmastectomy radiotherapy (PMRT) has proven benefits for certain patients with breast cancer; however, one of its complications is lymphedema. This study examines the incidence of and risk factors associated with lymphedema secondary to PMRT.

Methods: The charts of patients treated with mastectomy at Roswell Park Cancer Institute between January 1, 1995, and April 20, 2001, who received PMRT were reviewed.

Concordance with breast cancer pathology reporting practice guidelines.

Background: Accurate pathology reporting is important for treatment of breast cancer. The College of American Pathologists (CAP) distributed guidelines for reporting cancer specimens in 1998. The aim of this study was to determine community-wide concordance with CAP breast cancer reporting guidelines.

Provider case volume and outcome in the evaluation and treatment of patients with mammogram-detected breast carcinoma.

Background: Practice volume may affect the outcome of patients with breast carcinoma. Defining factors that influence the relation of volume and outcome for the diagnosis and treatment of breast carcinoma is important, because breast carcinoma is common, and care is decentralized.

Methods: Community-wide diagnosis and treatment of mammogram-detected breast carcinoma was examined using claims data from a single insurer representing 25% of the regional population.