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Association of clinical experiences with patient-reported outcomes among breast cancer surgery patients: breast cancer quality care study

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Abstract

Background

We aimed to clarify the association of breast cancer patients’ clinical experiences with patient-reported outcomes (PRO) of satisfaction with care, choice of the same type of surgery again, and health-related quality of life (HRQOL).

Methods

There were 2,403 (25.9%) of 9,283 eligible women who had undergone primary curative surgery for breast cancer in one of five selected hospitals between 1993 and 2002 who responded to a survey questionnaire including information about care experiences, satisfaction with care, and HRQOL.

Results

Treatment satisfaction was independently associated with cancer recurrence, problems obtaining surgery, receiving adjuvant hormonal therapy, being involved in treatment decisions, having opinions reflected in treatment decisions, experiencing treatment toxicity, or being hospitalized for treatment toxicity (P <0.01). Breast-conserving surgery with radiotherapy, receiving adjuvant hormone therapy, being involved in treatment decisions, having opinion reflected in treatment decisions, having no treatment toxicity, and receiving regular follow-up care were associated with choosing the same treatment over again (P < 0.01). Good care experiences, except for regular follow-ups, were significantly associated with good HRQOL in most functioning subscales (P < 0.01).

Conclusions

Our findings suggest that timely referral for treatment, reflection of the patient’s opinions in treatment decisions, and prevention of treatment toxicity might be important to HRQOL.

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References

  1. National Institutes of Health. (2000). Adjuvant therapy for breast cancer. NIH Consens Statement, 17, 1–35.

    Google Scholar 

  2. Hewitt, M., & Simone, J. V. (Eds.) (1999). Institute of Medicine Report: Ensuring Quality Cancer Care—National Cancer Policy Board, Institute of Medicine Report and National Research Council. Washington: National Academy Press, Institute of Medicine, Commission On Life Sciences National Research Council. Ensuring quality cancer care. Washington: National Academy Press.

  3. Arndt, V., Sturmer, T., Stegmaier, C., et al. (2003). Provider delay among patients with breast cancer in Germany: A population-based study. Journal of Clinical Oncology, 21, 1440–1446.

    Article  PubMed  Google Scholar 

  4. Hillner, B. E., Smith, T. J., & Desch, C. E. (2000). Hospital and physician volume or specialization and outcomes in cancer treatment: Importance in quality of cancer care. Journal of Clinical Oncology, 18, 2327–2340.

    PubMed  CAS  Google Scholar 

  5. Nattinger, A. B., Gottlieb, M. S., & Veum, J., et al. (1992). Geographic variation in the use of breast-conserving treatment for breast cancer. The New England Journal of Medicine, 326, 1102–1105.

    Article  PubMed  CAS  Google Scholar 

  6. Katz, S. J., Lantz, P. M., & Janz, N. K., et al. (2005). Patient involvement in surgery treatment decisions for breast cancer. Journal of Clinical Oncology, 23, 5526–5533.

    Article  PubMed  Google Scholar 

  7. Wennberg, J. E. (2002). Unwarranted variations in health care delivery: Implications for academic medical centres. Br Med J (Clinical Research Eds), 325, 961–964.

    Article  Google Scholar 

  8. Schneider, E. C., Malin, J. L., & Kahn, K. L., et al. (2004). Developing a system to assess the quality of cancer care: ASCO’s national initiative on cancer care quality. Journal of Clinical Oncology, 22, 2985–2991.

    Article  PubMed  Google Scholar 

  9. Ayanian, J. Z., Chrischilles, E. A., & Fletcher, R. H., et al. (2004). Understanding cancer treatment and outcomes: The Cancer Care Outcomes Research and Surveillance Consortium. Journal of Clinical Oncology, 22, 2992–2996.

    Article  PubMed  Google Scholar 

  10. Ganz, P. A. (2002). What outcomes matter to patients: A physician-researcher point of view. Medical Care, 40(S), III 11–19.

    Google Scholar 

  11. Lantz, P. M., Janz, N. K., & Fagerlin, A., et al. (2005). Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer. Health Services Research, 40, 745–767.

    Article  PubMed  Google Scholar 

  12. Mandelblatt, J., Armetta, C., & Yabroff, K. R., et al. (2004). Descriptive review of the literature on breast cancer outcomes: 1990 through 2000. Journal of the National Cancer Institute Monographs, 33, 8–44.

    Article  PubMed  Google Scholar 

  13. Malin, J. L., Schneider, E. C., & Epstein, A. M., et al. (2006). Results of the National Initiative for Cancer Care Quality: How can we improve the quality of cancer care in the United States? Journal of Clinical Oncology, 24, 626–634.

    Article  PubMed  Google Scholar 

  14. Hoffman, R. M., Hunt, W. C., & Gilliland, F. D., et al. (2003). Patient satisfaction with treatment decisions for clinically localized prostate carcinoma. Results from the Prostate Cancer Outcomes Study. Cancer, 97, 1653–1662.

    Article  PubMed  Google Scholar 

  15. Aaronson, N. K., Ahmedzai, S., & Bergman, B., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85, 365–376.

    Article  PubMed  CAS  Google Scholar 

  16. Sprangers, M. A., Groenvold, M., & Arraras, J. I., et al. (1996). The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: First results from a three-country field study. Journal of Clinical Oncology, 14, 2756–2768.

    PubMed  CAS  Google Scholar 

  17. Robins, J. M., Hernan, M. A., & Brumback, B. (2000). Marginal structural models and causal inference in epidemiology. Epidemiology, 11, 550–560.

    Article  PubMed  CAS  Google Scholar 

  18. MacKenzie, E. J., Rivara, F. P., & Jurkovich, G. J., et al. (2006). A national evaluation of the effect of trauma-center care on mortality. The New England Journal of Medicine, 354, 366–378.

    Article  PubMed  CAS  Google Scholar 

  19. Tan, Z. (2004). Efficient and robust causal inference: A distributional approach. Working paper no. 48. Baltimore: Johns Hopkins University, Department of Biostatistics. (Accessed December 30, 2005, at http://www.bepress.com/cgi/viewcontent.cgi?article=1048&context=jhubiostat.).

  20. Potter, F. (1990). A study of procedures to identify and trim extreme sampling weights. In: Proceedings of the section on survey research methods (pp. 225–230). Washington: American Statistical Association.

  21. Fayers, P. M. (2001). Interpreting quality of life data: Population-based reference data for the EORTC QLQ C-30. European Journal of Cancer, 37, 1331–1334.

    Article  PubMed  CAS  Google Scholar 

  22. Silliman, R. A., Troyan, S. L., & Guadagnoli, E., et al. (1997). The impact of age, marital status, and physician–patient interactions on the care of older women with breast carcinoma. Cancer, 80, 1326–1334.

    Article  PubMed  CAS  Google Scholar 

  23. Greene, M. G., Adelman, R. D., & Rizzo, C. (1996) Problems in communication between physicians and older patients. Journal of Geriatric Psychiatry, 29, 13–32.

    Google Scholar 

  24. de Haes, J. C., Curran, D., & Aaronson, N. K., et al. (2003). Quality of life in breast cancer patients aged over 70 years, participating in the EORTC 10850 randomised clinical trial. European Journal of Cancer, 39, 945–951.

    Article  PubMed  Google Scholar 

  25. Jefford, M., & Tattersall, M. H. (2002). Informing and involving cancer patients in their own care. The Lancet Oncology, 3, 629–637.

    Article  PubMed  Google Scholar 

  26. Thorne, S. E., Harris, S. R., & Hislop, T. G., et al. (1999). The experience of waiting for diagnosis after an abnormal mammogram. The Breast Journal, 5, 42–51.

    Article  PubMed  Google Scholar 

  27. Mandelblatt, J. S., Edge, S. B., & Meropol, N. J., et al. (2003). Predictors of long-term outcomes in older breast cancer survivors: Perceptions versus patterns of care. Journal of Clinical Oncology, 21, 855–863.

    Article  PubMed  Google Scholar 

  28. Jansen, S. J., Otten, W., & van de Velde, C. J., et al. (2004). The impact of the perception of treatment choice on satisfaction with treatment, experienced chemotherapy burden and current quality of life. British Journal of Cancer, 91, 56–61.

    Article  PubMed  CAS  Google Scholar 

  29. Degner, L. F., Kristjanson, L. J., & Bowman, D., et al.(1997). Information needs and decisional preferences in women with breast cancer. JAMA: The Journal of the American Medical Association, 277, 1485–92.

    Article  CAS  Google Scholar 

  30. Yabroff, K. R., & Kerner, J. F. (2005). Variations in surgery for early-stage breast cancer: What are we measuring? Lancet, 366, 188–190.

    Article  PubMed  Google Scholar 

  31. Molenaar, S., Sprangers, M. A., & Rutgers, E. J., et al. (2001). Decision support for patients with early-stage breast cancer: Effects of an interactive breast cancer CDROM on treatment decision, satisfaction, and quality of life. Journal of Clinical Oncology, 19, 1676–1687.

    PubMed  CAS  Google Scholar 

  32. Phillips, K. A., Milne, R. L., & Buys, S., et al. (2005). Agreement between self-reported breast cancer treatment and medical records in a population-based Breast Cancer Family Registry. Journal of Clinical Oncology, 23, 4679–4686.

    Article  PubMed  Google Scholar 

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Acknowledgment

This work was supported by National Cancer Center Grant 0410150-2 and 0710421-1

Author information

Authors and Affiliations

  1. Department of Surgery, Seoul National University Hospital, Seoul, Korea

    Dong Young Noh

  2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Seok Jin Nam

  3. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Se Hyun Ahn

  4. Department of Surgery, Yonsei University Medical Center, Seoul, Korea

    Byeong Woo Park

  5. Center for Breast Cancer, National Cancer Center, Goyang, Gyeonggi, Korea

    Eun Sook Lee

  6. Quality of Cancer Care Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, 809 Madu-dong, Ilsan-gu, Goyang-si, Gyeonggi-do, 411-769, Korea

    Myung Kyung Lee, Soo Hyun Kim, Yoo Min Kim, Sang Min Park & Young Ho Yun

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  1. Dong Young Noh
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Corresponding author

Correspondence to Young Ho Yun.

Additional information

Dong Young Noh and Seok Jin Nam contributed equally to this work as first authors.

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Noh, D.Y., Nam, S.J., Ahn, S.H. et al. Association of clinical experiences with patient-reported outcomes among breast cancer surgery patients: breast cancer quality care study. Qual Life Res 17, 215–225 (2008). https://doi.org/10.1007/s11136-007-9299-9

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  • DOI: https://doi.org/10.1007/s11136-007-9299-9

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