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- Adverse Events (2)
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- (-) Cancer: Breast Cancer (24)
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- Clinician-Patient Communication (2)
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- (-) Patient-Centered Outcomes Research (24)
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- Patient Self-Management (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (4)
- Research Methodologies (1)
- Risk (3)
- Shared Decision Making (5)
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- Surgery (5)
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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
1 to 24 of 24 Research Studies DisplayedWernli KJ, Smith RE, Henderson LM
Decision quality and regret with treatment decisions in women with breast cancer: pre-operative breast MRI and breast density.
The authors evaluated self-report of decision quality and regret with breast cancer surgical treatment by pre-operative breast MRI use in women recently diagnosed with breast cancer. They found that breast MRI use in the diagnostic work-up of breast cancer does not negatively alter women's perceptions of surgical treatment decisions in early survivorship.
AHRQ-funded; HS018366.
Citation: Wernli KJ, Smith RE, Henderson LM .
Decision quality and regret with treatment decisions in women with breast cancer: pre-operative breast MRI and breast density.
Breast Cancer Res Treat 2022 Aug;194(3):607-16. doi: 10.1007/s10549-022-06648-7..
Keywords: Cancer: Breast Cancer, Cancer, Shared Decision Making, Women, Patient-Centered Outcomes Research
Loo S, Mullikin K, Robbins C
Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study.
This study’s goal was to assess the implementation of the 2018 Translating Research Into Practice (TRIP), an evidence-based patient navigation intervention aimed at addressing breast cancer care disparities, across six Boston hospitals. Patient navigator team member perspectives regarding implementation barriers and facilitators one-year post-study implementation were assessed. Seventeen interviews were conducted with patient navigators, patient navigator supervisors, and designated clinical champions. The following benefits were identified by participants: 1) increased networking and connections for navigators across clinical sites (Cosmopolitanism), 2) formalization of the patient navigation process (Goals and Purpose, Access to Knowledge and Information, and Relative Advantage), and 3) flexibility within the TRIP intervention that allowed for diversity in implementation and use of TRIP components across sites (Adaptability). Barriers included documentation requirements and the structured patient follow up guidelines that did not always align with the timeline of existing site navigation processes.
AHRQ-funded; HS022242.
Citation: Loo S, Mullikin K, Robbins C .
Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study.
BMC Health Serv Res 2022 May 21;22(1):683. doi: 10.1186/s12913-022-08090-3..
Keywords: Patient-Centered Healthcare, Cancer: Breast Cancer, Cancer, Patient-Centered Outcomes Research, Evidence-Based Practice
Sauder CAM, Bateni SB, Davidson AJ
Breast conserving surgery compared with mastectomy in male breast cancer: a brief systematic review.
The surgical guidelines for male breast cancer (MBC) have been largely guided by female-predominant clinical trials. Because no clinical trial has been conducted to examine the surgical treatment of MBC, the investigators performed a systematic review comparing the survival of patients with MBC who had undergone breast conserving surgery (BCS) and those who had undergone mastectomy and evaluated the patients' radiotherapy compliance after BCS.
AHRQ-funded; HS022236.
Citation: Sauder CAM, Bateni SB, Davidson AJ .
Breast conserving surgery compared with mastectomy in male breast cancer: a brief systematic review.
Clin Breast Cancer 2020 Jun;20(3):e309-e14. doi: 10.1016/j.clbc.2019.12.004..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Dominici LS, Rosenberg SM
Ductal carcinoma in situ (DCIS): the importance of patient-reported outcomes (PRO).
This review summarizes patient-reported outcomes (PROs) frequently assessed in the setting of a ductal carcinoma in situ (DCIS) diagnosis. Findings indicated that PROs provide critical information regarding the experiences of women following a DCIS diagnosis. Continued inclusion of PROs in clinical trials is warranted, further informing treatment decisions and adequately preparing patients for what to expect following treatment.
AHRQ-funded; HS023680.
Citation: Dominici LS, Rosenberg SM .
Ductal carcinoma in situ (DCIS): the importance of patient-reported outcomes (PRO).
Curr Breast Cancer Rep 2020 Jun;12(2):90-97. doi: 10.1007/s12609-020-00363-2..
Keywords: Cancer: Breast Cancer, Cancer, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Women, Quality of Life
Mahorter SS, Knerr S, Bowles EJA
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
This study examined knowledge of breast density as an important breast cancer risk factor among a set of women in a health system-embedded trial who had clinically elevated breast cancer risk 1 year before state-mandated density disclosure. The majority of the women (91%) had heard of breast density and were aware of its masking effect (87%). Only 60% had ever discussed their breast density with a provider.
AHRQ-funded; HS022982.
Citation: Mahorter SS, Knerr S, Bowles EJA .
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
Cancer 2020 Apr 15;126(8):1614-21. doi: 10.1002/cncr.32711..
Keywords: Cancer: Breast Cancer, Cancer, Women, Communication, Clinician-Patient Communication, Risk, Patient-Centered Outcomes Research
Killelea BK, Evans SB, Mougalian SS
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
This study examined perceptions of older women with stage I estrogen-receptor-positive breast cancer who underwent lumpectomy and were considering or receiving radiotherapy. Perceptions among 63 older women was that radiotherapy would reduce their 10-year-risk of local recurrent by an average of 18.7% although the literature showed only an 8% risk reduction. Participants who had the perception of a larger benefit were more likely to receive radiotherapy treatment.
AHRQ-funded; HS023900.
Citation: Killelea BK, Evans SB, Mougalian SS .
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
Breast J 2020 Feb;26(2):231-34. doi: 10.1111/tbj.13518..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Patient-Centered Outcomes Research, Shared Decision Making
Bateni SB, Davidson AJ, Arora M
Is breast-conserving therapy appropriate for male breast cancer patients? A national cancer database analysis.
The purpose of this study was to compare overall survival rates among male breast cancer patients who underwent breast-conserving therapy (BCT) versus mastectomy. A retrospective analysis identified 8445 stage I-II male breast cancer patients from the National Cancer Database and grouped them according to surgical and radiation therapy (RT). Most of the patients underwent total mastectomy, while 18.2% underwent BCT, 12.4% underwent total mastectomy with RT, and 8.2% underwent partial mastectomy alone. Partial mastectomy alone, total mastectomy alone, and total mastectomy with RT were associated with worse overall survival rates compared with BCT. The authors conclude that BCT is associated with greater survival, but the underlying mechanisms of this association warrant further study.
AHRQ-funded; HS022236.
Citation: Bateni SB, Davidson AJ, Arora M .
Is breast-conserving therapy appropriate for male breast cancer patients? A national cancer database analysis.
Ann Surg Oncol 2019 Jul;26(7):2144-53. doi: 10.1245/s10434-019-07159-4..
Keywords: Cancer, Cancer: Breast Cancer, Shared Decision Making, Mortality, Outcomes, Patient-Centered Outcomes Research
Arasu VA, Miglioretti DL, Sprague BL
Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk.
The purpose of this study was to evaluate comparative associations of breast magnetic resonance imaging (MRI) background parenchymal enhancement (BPE) and mammographic breast density with subsequent breast cancer risk. The investigators concluded that BPE was associated with future invasive breast cancer risk independent of breast density. They suggest that BPE should be considered for risk prediction models for women undergoing breast MRI.
AHRQ-funded; HS018366.
Citation: Arasu VA, Miglioretti DL, Sprague BL .
Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk.
J Clin Oncol 2019 Apr 20;37(12):954-63. doi: 10.1200/jco.18.00378..
Keywords: Cancer, Cancer: Breast Cancer, Imaging, Patient-Centered Outcomes Research, Risk, Women
Punglia RS, Jiang W, Lipsitz SR
Clinical risk score to predict likelihood of recurrence after ductal carcinoma in situ treated with breast-conserving surgery.
In this article, the investigators developed a score to provide individualized information about ipsilateral breast tumor recurrence risk to guide treatment decisions. The authors indicate that their simple, no-cost risk score may be used by patients and physicians to facilitate preference-based decision-making about ductal carcinoma in situ management informed by a more accurate understanding of risks.
AHRQ-funded; 29020050016I.
Citation: Punglia RS, Jiang W, Lipsitz SR .
Clinical risk score to predict likelihood of recurrence after ductal carcinoma in situ treated with breast-conserving surgery.
Breast Cancer Res Treat 2018 Feb;167(3):751-59. doi: 10.1007/s10549-017-4553-5..
Keywords: Cancer: Breast Cancer, Risk, Surgery, Patient-Centered Outcomes Research
Yanez BR, Buitrago D, Buscemi J
Study design and protocol for My Guide: an e-health intervention to improve patient-centered outcomes among Hispanic breast cancer survivors.
This article describes a randomized controlled trial designed to investigate the feasibility and efficacy of a Smartphone application intended to improve health-related quality of life (HRQoL) among Hispanic breast cancer survivors. Participants are randomized to receive either the intervention application My Guide, or the health education control condition application My Health for six weeks, and also receive weekly telecoaching to enhance adherence to both applications. The study's outcomes are measured prior to intervention, immediately after, and eight weeks following initial application use.
AHRQ-funded; HS023011.
Citation: Yanez BR, Buitrago D, Buscemi J .
Study design and protocol for My Guide: an e-health intervention to improve patient-centered outcomes among Hispanic breast cancer survivors.
Contemp Clin Trials 2018 Feb;65:61-68. doi: 10.1016/j.cct.2017.11.018..
Keywords: Cancer, Cancer: Breast Cancer, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Quality of Life, Racial and Ethnic Minorities, Women
Kelly G, Wang SY, Lucas G
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
In this study, the investigators conducted a process evaluation of ongoing activities of a Patient Advisory Committee (PAC) formed around the development of an individualized decision aid for older women with early stage breast cancer. They indicated that their results suggested that engaging committee members in a process of evaluation and collective reflection during a research collaboration can break down barriers to collaboration, build relationships, create opportunities for co-learning and strengthen researchers' capacity to engage meaningfully with stakeholders.
AHRQ-funded; HS023900.
Citation: Kelly G, Wang SY, Lucas G .
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
Prog Community Health Partnersh 2017;11(3):243-51. doi: 10.1353/cpr.2017.0029..
Keywords: Cancer, Cancer: Breast Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Chetta MD, Aliu O, Zhong L
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
This study aims to assess the morbidity associated with various breast reconstruction techniques in irradiated patients. It found that overall complication rates were 45.3 percent and 30.8 percent for patients with implant and autologous reconstruction, respectively. Failure of reconstruction occurred in 29.4 percent of patients with implant reconstruction compared with 4.3 percent of patients with autologous reconstruction.
AHRQ-funded; HS023313.
Citation: Chetta MD, Aliu O, Zhong L .
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
Plast Reconstr Surg 2017 Apr;139(4):783-92. doi: 10.1097/prs.0000000000003168.
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Keywords: Cancer, Cancer: Breast Cancer, Surgery, Adverse Events, Patient-Centered Outcomes Research
Mamtani R, Clark AS, Scott FI
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
The researchers examined the rates of breast cancer recurrence in patients with immune-mediated disease and treated breast cancer who received therapy with methotrexate, thiopurines, or anti-tumor necrosis factor (anti-TNF). They found that the risk of breast cancer recurrence in patients who received methotrexate, thiopurine, or anti-TNF therapy was not statistically significantly increased, although they did not rule out a 2-fold or greater increased risk in those treated with thiopurines.
AHRQ-funded; HS021110; HS018517.
Citation: Mamtani R, Clark AS, Scott FI .
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
Arthritis Rheumatol 2016 Oct;68(10):2403-11. doi: 10.1002/art.39738.
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Keywords: Cancer: Breast Cancer, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Arthritis
Ridner SH, Rhoten BA, Radina ME
Breast cancer survivors' perspectives of critical lymphedema self-care support needs.
The purpose of this paper was to solicit breast cancer survivors' perspectives on the variety of issues they face related to lymphedema self-care and to identify support needs perceived as critical for managing their chronic medical condition. The authors found that lack of support and the failure of others to recognize lymphedema as a chronic condition set this patient population apart from other patients with chronic diseases and decreases the amount of help needed to manage the condition.
AHRQ-funded; HS022990.
Citation: Ridner SH, Rhoten BA, Radina ME .
Breast cancer survivors' perspectives of critical lymphedema self-care support needs.
Support Care Cancer 2016 Jun;24(6):2743-50. doi: 10.1007/s00520-016-3089-2.
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Keywords: Cancer: Breast Cancer, Chronic Conditions, Patient-Centered Outcomes Research, Patient Self-Management
Lyons EJ, Baranowski T, Basen-Engquist KM
Testing the effects of narrative and play on physical activity among breast cancer survivors using mobile apps: study protocol for a randomized controlled trial.
This paper described a study to determine the effectiveness of an intervention that combines narrative and gaming to encourage sustained physical activity in postmenopausal breast cancer survivors. The primary outcome of the study is minutes of moderate to vigorous physical activity at six months. Other objectively measured outcomes include fitness and physical function. Self-reported outcomes include quality of life, depression, and motivation.
AHRQ-funded; HS022134.
Citation: Lyons EJ, Baranowski T, Basen-Engquist KM .
Testing the effects of narrative and play on physical activity among breast cancer survivors using mobile apps: study protocol for a randomized controlled trial.
BMC Cancer 2016 Mar 9;16:202. doi: 10.1186/s12885-016-2244-y.
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Keywords: Cancer: Breast Cancer, Comparative Effectiveness, Lifestyle Changes, Patient-Centered Outcomes Research, Telehealth
Farias AJ, Du XL
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
The aim of this study was to determine whether there are racial/ethnic differences in initiation and timing of adjuvant endocrine therapy (AET) after Medicare Part D drug coverage. After controlling for all variables, only Asian women were found to have a greater odds of initiation of overall AET compared to non-Hispanic white women. Hispanic Mexicans and non-Hispanic black patients had a significantly lower odds of tamoxifen initiation.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
Med Oncol 2016 Feb;33(2):19. doi: 10.1007/s12032-016-0732-1.
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Keywords: Cancer: Breast Cancer, Treatments, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Yi H, Xiao T, Thomas PS
Barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools.
The investigators identified barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. They found that barriers barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and that facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool.
AHRQ-funded; HS019313.
Citation: Yi H, Xiao T, Thomas PS .
Barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools.
AMIA Annu Symp Proc 2015 Nov 5;2015:1352-60.
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Keywords: Cancer: Breast Cancer, Shared Decision Making, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Clinician-Patient Communication
Du XL, Zhang Y, Parikh RC
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
The purpose of this study was to compare the effectiveness of chemotherapy in prolonging survival according to age in breast and colon cancer. It found that the effectiveness of chemotherapy decreased with age in participants with breast cancer, in whom chemotherapy appears to be effective until age 79 except for the doxorubicin-cyclophosphamide combination, which was effective in participants aged 80 to 84.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Parikh RC .
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
J Am Geriatr Soc 2015 Aug;63(8):1570-82. doi: 10.1111/jgs.13523..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research
Tamirisa NP, Sheffield KM, Parmar AD
Surgeon and facility variation in the use of minimally invasive breast biopsy in Texas.
The researchers aimed to determine the variation in use attributable to the surgeon and facility and determine the patient, surgeon, and facility characteristics associated with the use of minimally invasive breast biopsy (MIBB). They found that lower surgeon and facility volume, longer surgeon years in practice, and smaller facility bed size were associated with lower rates of MIBB use.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Sheffield KM, Parmar AD .
Surgeon and facility variation in the use of minimally invasive breast biopsy in Texas.
Ann Surg 2015 Jul;262(1):171-8. doi: 10.1097/sla.0000000000000883..
Keywords: Cancer: Breast Cancer, Shared Decision Making, Patient-Centered Outcomes Research, Surgery
Pruitt SL, Lee SJ, Tiro JA
Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009.
The authors investigated whether residential segregation was associated with mortality among urban women with breast cancer. They found that greater black segregation and Hispanic segregation were adversely associated with cause-specific mortality and all-cause mortality.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Lee SJ, Tiro JA .
Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009.
Cancer 2015 Jun 1;121(11):1845-55. doi: 10.1002/cncr.29282..
Keywords: Cancer: Breast Cancer, Mortality, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Urban Health
Wang X, Du XL
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
The researchers assessed socio-demographic, geographic, and other variations in the receipt of hormone therapy among patients with hormone receptor-positive breast cancer as well as adherence to hormone therapy within 1-year follow-up. They found that found that increasing age was significantly associated with a decreased receipt of hormone therapy and aromatase inhibitors in all hormone receptor-positive breast cancer patients after adjusting for other factors regardless of whether chemotherapy was received.
AHRQ-funded; HS018956.
Citation: Wang X, Du XL .
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
Med Oncol 2015 May;32(5):154. doi: 10.1007/s12032-015-0599-6..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Determinants of Health
Gidengil CA, Predmore Z, Mattke S
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
The purpose of this study was to identify and analyze recently published cases of breast implant-associated anaplastic large cell lymphoma (ALCL), with an emphasis on diagnosis, staging, treatment, and outcomes. The researchers found that, of 54 cases, most patients presented with a seroma, approximately half were associated with the capsule, most presented as stage IE, and all but one case were ALK-negative. Most patients received chemotherapy and radiation therapy, and 11 percent received stem cell transplants. Approximately one-quarter recurred, and 9 percent died.
AHRQ-funded; HS000029.
Citation: Gidengil CA, Predmore Z, Mattke S .
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
Plast Reconstr Surg 2015 Mar;135(3):713-20. doi: 10.1097/prs.0000000000001037.
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Keywords: Adverse Events, Cancer: Breast Cancer, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Surgery
Wheeler SB, Kohler RE, Reeder-Hayes KE
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
The researchers sought to characterize endocrine therapy (ET) use in a low-income Medicaid-insured population in North Carolina. They found that, of 222 women meeting the inclusion criteria, only 50 percent filled a prescription for ET. Results suggest substantial underutilization of ET in this population.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kohler RE, Reeder-Hayes KE .
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
J Cancer Surviv 2014 Dec;8(4):603-10. doi: 10.1007/s11764-014-0365-3..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Medication, Patient-Centered Outcomes Research
Nurgalieva ZZ, Franzini L, Morgan RO
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
This study reports on the impact of nodal surgery utilization on survival among white, African American, Hispanic, and Asian women in a large population of women with breast cancer. It found that the disparities in survival among African American and Hispanic women with breast cancer are not explained by nodal surgery utilization among women with micrometastasis and macrometastasis in sentinel lymph nodes.
AHRQ-funded; HS018956.
Citation: Nurgalieva ZZ, Franzini L, Morgan RO .
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
Am J Manag Care 2013 Oct;19(10):805-10..
Keywords: Cancer: Breast Cancer, Comparative Effectiveness, Disparities, Patient-Centered Outcomes Research, Racial and Ethnic Minorities