National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
26 to 50 of 197 Research Studies DisplayedRosenberg SM, Gierisch JM, Revette AC
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
This study investigated the impact of a ductal carcinoma in situ (DCIS) diagnosis by engaging self-identified patients regarding their experience. Findings showed that, in a large, national sample, participants with a history of DCIS reported confusion and concern about the diagnosis and treatment, which caused worry and significant uncertainty.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Gierisch JM, Revette AC .
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
Cancer 2022 Apr 15;128(8):1676-83. doi: 10.1002/cncr.34126..
Keywords: Cancer: Breast Cancer, Cancer, Shared Decision Making, Women, Patient-Centered Healthcare, Clinician-Patient Communication, Patient and Family Engagement, Communication
Saulsberry L, Liao C, Huo D
Hypofractionated radiation therapy for breast cancer: financial risk and expenditures in the United States, 2008 to 2017.
This study examined the costs of hypofractionated whole breast irradiation (HF-WBI) compared with conventional whole breast irradiation (CF-WBI) and investigated the influences of patient characteristics and commercial insurance on HF-WBI use. This retrospective study used private employer-sponsored insurance claims to obtain a pooled cross-sectional evaluation of radiation therapy in patients with commercial insurance from 2008 to 2017. The study population included female patients with early-stage breast cancer treated with lumpectomy and whole breast irradiation. A total of 15,869 women received HF-WBI, and 59,328 CF-WBI. A higher proportion of college graduates and greater mixed racial composition was associated with increased HF-WBI use. Mean insurer-paid radiation therapy expenditures were significantly lower for HB-WBI versus CF-WBI (adjusted difference $6375). Mean patient out-of-pocket expenditures for HF-WBI was $139 less than for CF-WBI. Geographic variation existed across the United States with no consistent relationship between HF-WBI use and correspondent average cost differences.
AHRQ-funded; HS025806.
Citation: Saulsberry L, Liao C, Huo D .
Hypofractionated radiation therapy for breast cancer: financial risk and expenditures in the United States, 2008 to 2017.
Int J Radiat Oncol Biol Phys 2022 Mar;112(3):654-62. doi: 10.1016/j.ijrobp.2021.10.005..
Keywords: Cancer: Breast Cancer, Cancer, Healthcare Costs, Women
Tice JA, Gard CC, Miglioretti DL
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
This study’s purpose was to assess the consistency of Breast Imaging Reporting and Data System (BI-RADS) breast density reporting comparing digital breast tomosynthesis (DBT) with digital mammography (DM) and to evaluate density as a breast cancer risk factor when assessed using DM versus DBT. A secondary analysis of data from the Breast Cancer Surveillance Consortium was used from 342,149 women aged 40-79 years who underwent at least two screening mammography examinations less than 36 months apart. There were no significant differences in breast density assessment in pairs consisting of one DM and one DBT examination (57,516 of 74,729 [77%]), two DM examinations (238,678 of 301,743 [79%]), and two DBT examinations (20,763 of 26,854). Results were similar when pair analysis was restricted to readings by the same radiologist. The breast cancer hazard ratios (HRs) for breast density were similar for DM and DBT. The HRs for density acquired using DM and DBT, respectively, were 0.55 and 0.37 for almost entirely fat, 1.47 and 1.36 for heterogeneously dense, and 1.72 and 2.05 for extremely dense breasts.
AHRQ-funded; HS018366.
Citation: Tice JA, Gard CC, Miglioretti DL .
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
Radiology 2022 Feb; 302(2):286-92. doi: 10.1148/radiol.2021204579..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Screening, Diagnostic Safety and Quality
Rosenberg SM, O'Neill A, Sepucha K
Quality of life following receipt of adjuvant chemotherapy with and without bevacizumab in patients with lymph node-positive and high-risk lymph node-negative breast cancer.
The authors sought to describe and evaluate factors associated with diminished quality of life (QOL) following completion of active breast cancer treatment. They conducted a survey with patients 18 months after enrollment and found that the addition of bevacizumab to chemotherapy was not negatively associated with QOL at 18 months. A substantial proportion of participants reported problems related to pain or discomfort and anxiety or depression; as many reported problems can be amenable to intervention, timely referral to supportive resources, especially for women of color and those who have more extensive local therapy, is indicated.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, O'Neill A, Sepucha K .
Quality of life following receipt of adjuvant chemotherapy with and without bevacizumab in patients with lymph node-positive and high-risk lymph node-negative breast cancer.
JAMA Netw Open 2022 Feb;5(2):e220254. doi: 10.1001/jamanetworkopen.2022.0254..
Keywords: Quality of Life, Cancer: Breast Cancer, Cancer, Women
Dossett LA, Mott NM, Bredbeck BC
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
The purpose of this study was to examine the role that an individual’s maximizing-minimizing trait, an inherent preference for more or less medical care, may influence the preference for low-value care in the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women 70 years of age or higher with early-stage, hormone-receptor positive invasive breast cancer. The researchers recruited women 70 years of age or higher (n=1600) who were maximizers (515), minimizers (550), or neutral (535), and presented them with a hypothetical breast cancer diagnosis and then randomized exposure to one of three follow-up messages. Messages included: 1) maximizer-tailored, 2) minimizer-tailored, or 3) neutral. The study reported that higher maximizing tendency correlated positively with electing both SLNB and radiotherapy on logistic regression. Any maximizer- or minimizer-tailoring decreased preference for SLNB in maximizing and neutral women but had no effect in minimizing women. Tailoring had no impact on radiotherapy decision, except for an increased probability of minimizers electing radiotherapy when presented with maximizer-tailored messaging. The study concluded that among women facing a hypothetical breast cancer diagnosis, tendencies for maximizing-minimizing are correlated with preferences for treatment.
AHRQ-funded; HS026030.
Citation: Dossett LA, Mott NM, Bredbeck BC .
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
J Surg Res 2022 Feb;270:503-12. doi: 10.1016/j.jss.2021.10.005..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Shared Decision Making, Clinician-Patient Communication, Communication
Roberson ML, Nichols HB, Wheeler
Validity of breast cancer surgery treatment information in a state-based cancer registry.
Surgery is an important part of early stage breast cancer treatment that affects overall survival. Statewide cancer registries contain data on first course of cancer treatment for all patients diagnosed with cancer but the accuracy of these data are uncertain. In this study, the authors examined validity of breast cancer surgery treatment information in a state-based cancer registry.
AHRQ-funded; HS027299.
Citation: Roberson ML, Nichols HB, Wheeler .
Validity of breast cancer surgery treatment information in a state-based cancer registry.
Cancer Causes Control 2022 Feb;33(2):261-69. doi: 10.1007/s10552-021-01520-3..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Registries
Schapira L, Zheng Y, Gelber SI
Trajectories of fear of cancer recurrence in young breast cancer survivors.
This prospective cohort study examined the effects of fear of cancer recurrence (FCR) among 965 young women enrolled in the Young Women’s Breast Cancer Study who are ≤40 years and had been diagnosed with stage 0 to stage III breast cancer. These women completed the 3-item Lasry Fear or Recurrence Index survey. Five FCR trajectories were identified with a majority of participants having moderate or high FCR that improved over time. A total of 6.9% participants had moderate FCR that worsened, and 21.7% had a high FCR at baseline that didn’t go lower throughout the study. White women had higher odds of being in a trajectory that improved over time than non-White women. One-third of women with severe FCR did not improve or worsened over 5 years after diagnosis. The authors indicated these women may require targeted mental health intervention.
AHRQ-funded; HS023680.
Citation: Schapira L, Zheng Y, Gelber SI .
Trajectories of fear of cancer recurrence in young breast cancer survivors.
Cancer 2022 Jan 15;128(2):335-43. doi: 10.1002/cncr.33921..
Keywords: Cancer: Breast Cancer, Cancer, Women
Kang MM, Hasan Y, Waller J
Has hypofractionated whole-breast radiation therapy become the standard of care in the United States? An updated report from National Cancer Database.
This study examined trends in the use of hypofractionated whole-breast irradiation (HF-WBI) over time in the United States and factors related to its adoption for patients undergoing a lumpectomy from 2004 to 2016. Lumpectomy patients in the National Cancer Database were identified, with 688,079 early-stage invasive breast cancer patients, and 248,218 patients diagnosed with ductal carcinoma in situ. Among invasive cancer patients, HB-WBI use increased from 0.7% in 2004 to 38.1% in 2016. Among ductal carcinoma in situ patients, HB-WBI use increased significantly from 0.42% in 2004 to 34.3% in 2016. Factors associated with HB-WBI use included age, geographic location, race/ethnicity, tumor stage, grade, treating facility type, and volume.
AHRQ-funded; HS025806.
Citation: Kang MM, Hasan Y, Waller J .
Has hypofractionated whole-breast radiation therapy become the standard of care in the United States? An updated report from National Cancer Database.
Clin Breast Cancer 2022 Jan;22(1):e8-e20. doi: 10.1016/j.clbc.2021.05.016..
Keywords: Cancer: Breast Cancer, Cancer, Treatments, Practice Patterns
Hughes TM, Ellsworth B, Berlin NL
Statewide episode spending variation of mastectomy for breast cancer.
The purpose of this study was to characterize variations in episode spending related to volume and complication rates for mastectomy. A secondary study aim was to identify patient- and facility-level determinants of variation. The researchers assessed mean spending for 7,342 patients undergoing mastectomy at 74 facilities across Michigan state. The study found that mean 30-day spending by facility ranged from $11,129 to $20,830 and ninety-day spending ranged from $17,303 to $31,060. Patient-level factors associated with greater spending included bilateral surgery, simultaneous breast reconstruction, length of stay, and readmission. The researchers concluded that Michigan hospitals have considerable variation in mastectomy spending, and that reducing the frequency of bilateral surgery and length of stay may increase value, without risking patient safety or oncologic outcomes.
AHRQ-funded; HS026030.
Citation: Hughes TM, Ellsworth B, Berlin NL .
Statewide episode spending variation of mastectomy for breast cancer.
J Am Coll Surg 2022 Jan;234(1):14-23. doi: 10.1097/xcs.0000000000000005..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery
Alagoz O, Lowry KP, Kurian AW
Impact of the COVID-19 pandemic on breast cancer mortality in the US: estimates from collaborative simulation modeling.
This study’s objective was to project the impact of COVID-19 on future breast cancer mortality between 2020 and 2030. Three established Cancer Intervention and Surveillance Modeling Network breast cancer models were used to model reductions in mammography screening use, delays in symptomatic cancer diagnosis, and reduced use of chemotherapy for women with early-stage disease for the first 6 months of the pandemic with return to prepandemic patterns after that time. The models project by 2030 950 cumulative excess breast cancers deaths related to reduced screening, 1314 deaths associated with delayed diagnosis of symptomatic cases, and 151 deaths associated with reduced chemotherapy use in women with hormone positive, early-stage cancer.
AHRQ-funded; HS018366.
Citation: Alagoz O, Lowry KP, Kurian AW .
Impact of the COVID-19 pandemic on breast cancer mortality in the US: estimates from collaborative simulation modeling.
J Natl Cancer Inst 2021 Nov 2;113(11):1484-94. doi: 10.1093/jnci/djab097..
Keywords: COVID-19, Cancer: Breast Cancer, Cancer, Mortality, Women
Bowles EJA, O'Neill SC, Li T
Effect of a randomized trial of a web-based intervention on patient-provider communication about breast density.
This study evaluated a personalized web-based intervention between women and their providers designed to improve breast cancer risk communication. This randomized trial included women aged 40-69 years with 504 women in the control group and 492 women who used the intervention website. The website included information about breast density, personalized breast cancer risk, chemoprevention, and magnetic resonance imaging. Participants self-reported their communication about density with providers at 6 weeks and 12 months. Women in the intervention arm were 2.39 times more likely to report density communication at 6 weeks than the control arm. This effect persisted at 12 months. At 6 weeks the effect was only significant among women who reported versus those who did not report any previous density discussions. A quarter of women in each arm did not have a density conversation at any point during the study.
AHRQ-funded; HS022982.
Citation: Bowles EJA, O'Neill SC, Li T .
Effect of a randomized trial of a web-based intervention on patient-provider communication about breast density.
J Womens Health 2021 Nov;30(11):1529-37. doi: 10.1089/jwh.2021.0053.
AHRQ-funded; HS022982..
AHRQ-funded; HS022982..
Keywords: Communication, Women, Cancer: Breast Cancer, Cancer, Health Information Technology (HIT)
Kuijer A, Dominici LS, Rosenberg SM
Arm morbidity after local therapy for young breast cancer patients.
This study assessed patient-reported arm morbidity in the Young Women's Breast Cancer Study (YWS). Participants were over 1300 women with breast cancer diagnosed at age 40 or younger and who were enrolled in the YWS. Findings showed that high rates of self-reported arm morbidity in young breast cancer survivors were reported, particularly in patients receiving axillary lymph node dissection and post-mastectomy radiation therapy. Recommendations included attention to the risks and benefits of differing local therapy strategies for axillary lymph node dissection and post-mastectomy radiation therapy patients.
AHRQ-funded; HS023680.
Citation: Kuijer A, Dominici LS, Rosenberg SM .
Arm morbidity after local therapy for young breast cancer patients.
Ann Surg Oncol 2021 Oct;28(11):6071-82. doi: 10.1245/s10434-021-09947-3..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery
Dominici L, Hu J, Zheng Y
Association of local therapy with quality-of-life outcomes in young women with breast cancer.
Researchers examined the association of surgery with longer-term satisfaction and quality of life (QOL) in young breast cancer survivors. Participants were women 40 years or older who enrolled in the Young Women's Breast Cancer Study. The results suggested that local therapy in young breast cancer survivors is persistently associated with poorer scores in multiple QOL domains, particularly among those treated with mastectomy and radiotherapy, irrespective of breast reconstruction. Socioeconomic stressors also appear to play a role.
AHRQ-funded; HS023680.
Citation: Dominici L, Hu J, Zheng Y .
Association of local therapy with quality-of-life outcomes in young women with breast cancer.
JAMA Surg 2021 Oct;156(10):e213758. 2021. doi: 10.1001/jamasurg.2021.3758..
Keywords: Cancer: Breast Cancer, Cancer, Quality of Life, Women, Surgery
Sella T, Poorvu PD, Ruddy KJ
Impact of fertility concerns on endocrine therapy decisions in young breast cancer survivors.
The diagnosis and treatment of breast cancer can have profound effects on a young woman's family planning and fertility, particularly among women with hormone receptor-positive breast cancer. In this paper the authors discuss the Young Women's Breast Cancer Study, a multicenter cohort of women aged 40 years or younger and newly diagnosed with breast cancer from 2006 to 2016. The investigators concluded that concern about fertility was a contributor to adjuvant ET decisions among a substantial proportion of young breast cancer survivors.
AHRQ-funded; HS023680.
Citation: Sella T, Poorvu PD, Ruddy KJ .
Impact of fertility concerns on endocrine therapy decisions in young breast cancer survivors.
Cancer 2021 Aug 15;127(16):2888-94. doi: 10.1002/cncr.33596..
Keywords: Cancer: Breast Cancer, Cancer, Women, Pregnancy, Shared Decision Making
Baskin AS, Wang T, Bredbeck BC
Trends in contralateral prophylactic mastectomy utilization for small unilateral breast cancer.
This study describes trends in contralateral prophylactic mastectomy (CPM) utilization for small unilateral breast cancer instead of breast-conserving surgery (BCS) which is recommended. The authors used the National Cancer Database to identify women with unilateral, T1 breast cancer. Of the total cohort of 765,487, 69% underwent BCS and 31% chose mastectomy. Of 176,673 women aged 70 years or older, 75% underwent BCS and 25% chose mastectomy. CPM rates have increased in both cohorts since 2006. Patient factors such as younger age, white rate, private insurance, tumor factors, and facility factors were associated with increased CPM rates compared with unilateral mastectomy.
Citation: Baskin AS, Wang T, Bredbeck BC .
Trends in contralateral prophylactic mastectomy utilization for small unilateral breast cancer.
J Surg Res 2021 Jun;262:71-84. doi: 10.1016/j.jss.2020.12.057..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery, Prevention, Healthcare Utilization
Glenn BA, Nonzee NJ, Hamilton AS
Cancer surveillance and preventive services in a diverse sample of breast and colorectal cancer survivors.
This study assessed engagement in surveillance for recurrence, cancer screening, and other recommended preventive health services among breast and colorectal cancer survivors with early-onset disease (age 50 years and younger) who were diagnosed in California. Findings showed that, although the majority of survivors received appropriate surveillance for recurrence, engagement in other preventive health services varied substantially. Implications included efforts to address gaps in the use of recommended cancer screening and preventive health services among cancer survivors.
AHRQ-funded; HS000046.
Citation: Glenn BA, Nonzee NJ, Hamilton AS .
Cancer surveillance and preventive services in a diverse sample of breast and colorectal cancer survivors.
J Cancer Surviv 2021 Apr;15(2):213-23. doi: 10.1007/s11764-020-00925-4..
Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer, Prevention, Screening
Rauscher GH, Murphy AM, Qiu Q
The "sweet spot" revisited: optimal recall rates for cancer detection with 2D and 3D digital screening mammography in the Metro Chicago Breast Cancer Registry.
The authors examined the trade-offs for higher recall rates in terms of biopsy recommendations and cancer detection in mammography in a single large health care organization. 2D analog, 2D digital, and 3D digital mammography screenings among women 40-79 years old with cancer follow-up were examined. They found that the results of their investigation were in contrast to those of a recent study suggesting appropriateness of higher recall rates. They concluded that optimal cancer detection appeared to be in the recall rate range of 7-9% for both 2D digital mammography and 3D tomosynthesis.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Murphy AM, Qiu Q .
The "sweet spot" revisited: optimal recall rates for cancer detection with 2D and 3D digital screening mammography in the Metro Chicago Breast Cancer Registry.
AJR Am J Roentgenol 2021 Apr;216(4):894-902. doi: 10.2214/ajr.19.22429.
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Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Diagnostic Safety and Quality, Women, Prevention
Wang T, Bredbeck BC, Sinco B
Variations in persistent use of low-value breast cancer surgery.
Through the Choosing Wisely campaign, surgical specialties identified 4 low-value breast cancer operations. Preliminary data suggest varying rates of deimplementation and have identified patient-level and clinician-level determinants of continued overuse. However, little information exists about facility-level variation or determinants of differential deimplementation. In this retrospective cohort study the investigators sought to identify variation and determinants of persistent use of low-value breast cancer surgical care.
AHRQ-funded; HS026030.
Citation: Wang T, Bredbeck BC, Sinco B .
Variations in persistent use of low-value breast cancer surgery.
JAMA Surg 2021 Apr;156(4):353-62. doi: 10.1001/jamasurg.2020.6942..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Women
Miglioretti DL, Bissell MCS, Kerlikowske K
Assessment of a risk-based approach for triaging mammography examinations during periods of reduced capacity.
Breast cancer screening, surveillance, and diagnostic imaging services were profoundly limited during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic. The objective of this population-based cohort study was to develop a risk-based strategy for triaging mammograms during periods of decreased capacity. The investigators found that clinical indication and individual risk factors were associated with cancer detection and suggest these may be useful for prioritizing mammography in times and settings of decreased capacity.
AHRQ-funded; HS018366.
Citation: Miglioretti DL, Bissell MCS, Kerlikowske K .
Assessment of a risk-based approach for triaging mammography examinations during periods of reduced capacity.
JAMA Netw Open 2021 Mar;4(3):e211974. doi: 10.1001/jamanetworkopen.2021.1974..
Keywords: Screening, Cancer: Breast Cancer, Cancer, Women, Imaging, Access to Care, COVID-19
Lee CI, Zhu W, Onega T
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
This study looked at access to digital breast tomography (DBT) versus regular mammography and whether women of minority race/ethnicity and lower socioeconomic status experienced lower DBT access during the early adoption period and persistently lower DBT use over time. This cross-sectional study included 92 geographically diverse imaging facilities across 5 US states, with over 2.3 million screening examinations performed among women aged 40 to 89 years from January 1, 2011, to December 31, 2017. Data were analyzed from June 2019, to August 2020. Women who used DBT increased for all women from 3.3% in 2011 to 82.6% in 2017. In 2012, Black, Hispanic, Asian American, and women with less than a high school education had lower DBT access compared to White women attending the same facility and also college graduates. Lower DBT access continued over time regardless of the number of years after facility-level DBT adoption.
AHRQ-funded; HS018366.
Citation: Lee CI, Zhu W, Onega T .
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
JAMA Netw Open 2021 Feb;4(2):e2037546. doi: 10.1001/jamanetworkopen.2020.37546..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Access to Care, Women, Social Determinants of Health, Racial and Ethnic Minorities, Screening
Song H, Bergman A, Chen AT
Disruptions in preventive care: mammograms during the COVID-19 pandemic.
The objective of this study was to measure the extent to which the provision of mammograms was impacted by the COVID-19 pandemic and surrounding guidelines. The data source for the study were de-identified summary data derived from medical claims and eligibility files were provided by Independence Blue Cross for women receiving mammograms. The investigators concluded that the provision of mammograms has been significantly disrupted due to the COVID-19 pandemic.
AHRQ-funded; HS026116.
Citation: Song H, Bergman A, Chen AT .
Disruptions in preventive care: mammograms during the COVID-19 pandemic.
Health Serv Res 2021 Feb;56(1):95-101. doi: 10.1111/1475-6773.13596..
Keywords: COVID-19, Screening, Cancer: Breast Cancer, Cancer, Women, Prevention
Baskin AS, Wang T, Mott NM
Gaps in online breast cancer treatment information for older women.
This study’s goal was to assess the availability of web-based educational materials targeting older women facing early-stage breast cancer treatment. Routine use of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy offers no overall survival benefit and may not be perceived as desirable by older women. National guidelines allow omission of these treatments for older women. The authors systematically reviewed the top 25 hospital websites ranked as “Best Hospitals for Cancer” by U.S. News & World Report, as well as the websites of four prominent national cancer organizations. Only one national organization and no hospital websites included the recommendation to avoid routine SLNB. Only 2 hospitals and 2 national organizations included information for patients older than 70 years suggesting possible omission of adjuvant radiotherapy.
AHRQ-funded; HS026030.
Citation: Baskin AS, Wang T, Mott NM .
Gaps in online breast cancer treatment information for older women.
Ann Surg Oncol 2021 Feb;28(2):950-57. doi: 10.1245/s10434-020-08961-1..
Keywords: Elderly, Education: Patient and Caregiver, Health Information Technology (HIT), Cancer: Breast Cancer, Cancer, Women
Mott N, Wang T, Miller J
Medical maximizing-minimizing preferences in relation to low-value services for older women with hormone receptor-positive breast cancer: a qualitative study.
In this qualitative study, researchers conducted 30 semi-structured interviews with women age 70 or older without a previous diagnosis of breast cancer in order to elicit perspectives on breast cancer treatment in relation to their medical maximizing-minimizing preferences, as determined by the single-item maximizer-minimizer elicitation question (MM1). They found that medical maximizing-minimizing preferences in older women corresponded with preferences for breast cancer treatment options that guidelines identify as potentially unnecessary.
AHRQ-funded; HS026030.
Citation: Mott N, Wang T, Miller J .
Medical maximizing-minimizing preferences in relation to low-value services for older women with hormone receptor-positive breast cancer: a qualitative study.
Ann Surg Oncol 2021 Feb;28(2):941-49. doi: 10.1245/s10434-020-08924-6..
Keywords: Elderly, Women, Cancer: Breast Cancer, Cancer
Wang T, Baskin A, Miller J
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Guidelines allow for the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women >/= 70 years of age with hormone receptor-positive (HR +) breast cancer. Despite this, national data suggest these procedures have not been widely de-implemented. The objectives of this study were to evaluate trends in SLNB and post-lumpectomy radiotherapy utilization in patients who were eligible for omission and evaluate patient preferences as a target for de-implementation of low-value care.
AHRQ-funded; HS026030.
Citation: Wang T, Baskin A, Miller J .
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Ann Surg Oncol 2021 Feb;28(2):902-13. doi: 10.1245/s10434-020-08823-w..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Healthcare Utilization, Practice Patterns, Women
Eyrich NW, Sloss KR, Howard RA
Opioid prescribing exceeds consumption following common surgical oncology procedures.
Researchers aimed to compare opioid prescribing to opioid consumption for common surgical oncology procedures. They found that the median quantity of opioid prescribed was significantly larger than consumed following breast biopsy, lumpectomy, and mastectomy or wide local excision. The majority of patients reported receiving education on taking opioids, but only 27% received instructions on proper disposal; 82% of prescriptions filled resulted in unused opioids, and only 11% of these patients safely disposed of them. They concluded that their study demonstrated that opioid prescribing exceeds consumption following common surgical oncology procedures, thus indicating the potential for reductions in prescribing.
AHRQ-funded; HS023313.
Citation: Eyrich NW, Sloss KR, Howard RA .
Opioid prescribing exceeds consumption following common surgical oncology procedures.
J Surg Oncol 2021 Jan;123(1):352-56. doi: 10.1002/jso.26272..
Keywords: Opioids, Medication, Surgery, Cancer: Breast Cancer, Cancer, Practice Patterns, Pain