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Factors associated with ductal carcinoma in situ (DCIS) treatment patterns and patient-reported outcomes across a large integrated health network.
Kim, Hayeon; Wang, Hong; Demanelis, Kathryn; Clump, David A; Vargo, John A; Keller, Andrew; Diego, Mia; Gorantla, Vikram; Smith, Kenneth J; Rosenzweig, Margaret Q.
Affiliation
  • Kim H; Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA, USA. kimxhx2@upmc.edu.
  • Wang H; Department of Radiation Oncology, UPMC Hillman Cancer Center, Magee Women's Hospital, 300 Halket Street, Pittsburgh, PA, 15213, USA. kimxhx2@upmc.edu.
  • Demanelis K; Department of Biostatistics, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
  • Clump DA; Department of Biostatistics, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
  • Vargo JA; Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
  • Keller A; Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
  • Diego M; Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
  • Gorantla V; Department of Breast Surgery, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
  • Smith KJ; Department of Medical Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
  • Rosenzweig MQ; Clinical and Translational Science and Center for Research On Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Breast Cancer Res Treat ; 197(3): 683-692, 2023 Feb.
Article in En | MEDLINE | ID: mdl-36526807
ABSTRACT

PURPOSE:

To examine associations between ductal carcinoma in situ (DCIS) patients' characteristics, treating locations and DCIS treatments received and to pilot assessing quality-of-life (QoL) values among DCIS patients with diverse backgrounds.

METHODS:

We performed a retrospective tumor registry review of all patients diagnosed and treated with DCIS from 2018 to 2019 in the UPMC-integrated network throughout central and western Pennsylvania. Demographics, clinical information, and administered treatments were compiled from tumor registry records. We categorized contextual factors such as different hospital setting (academic vs. community), socioeconomic status based on the neighborhood deprivation index (NDI) as well as age and race. QoL survey was administered to DCIS patients with diverse backgrounds via QoL questionnaire breast cancer module 23 and qualitative assessment questions.

RESULTS:

A total of 912 patients were reviewed. There were no treatment differences noted for age, race, or NDI. Mastectomy rate was higher in academic sites than community sites (29 vs. 20.4%; p = 0.0045), while hormone therapy (HT) utilization rate was higher in community sites (74 vs. 62%; p = 0.0012). QoL survey response rate was 32%. Only HT side effects negatively affected in QoL scores and there was no significant difference in QoL domains and decision-making process between races, age, NDI, treatment groups, and treatment locations.

CONCLUSION:

Our integrated health network did not show chronically noted disparities arising from social determinates of health for DCIS treatments by implementing clinical pathways and system-wide peer review. Also, we demonstrated feasibility in collecting QoL for DCIS women with diverse backgrounds and different socioeconomic statuses.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Breast Neoplasms / Carcinoma, Ductal, Breast / Carcinoma, Intraductal, Noninfiltrating Type of study: Guideline / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspects: Patient_preference Limits: Female / Humans Language: En Journal: Breast Cancer Res Treat Year: 2023 Document type: Article Affiliation country: United States Publication country: HOLANDA / HOLLAND / NETHERLANDS / NL / PAISES BAJOS / THE NETHERLANDS

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Breast Neoplasms / Carcinoma, Ductal, Breast / Carcinoma, Intraductal, Noninfiltrating Type of study: Guideline / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspects: Patient_preference Limits: Female / Humans Language: En Journal: Breast Cancer Res Treat Year: 2023 Document type: Article Affiliation country: United States Publication country: HOLANDA / HOLLAND / NETHERLANDS / NL / PAISES BAJOS / THE NETHERLANDS