Impact of Second Opinions in Breast Cancer Diagnostics and Treatment: A Retrospective Analysis
| Autor: | M. A. Hillen, Carolien H. Smorenburg, E. Heeg, Y. A. Civil, Leonie A. E. Woerdeman, Emma J. Groen, M.T.F.D. Vrancken Peeters, H.A.O. Winter-Warnars |
|---|---|
| Přispěvatelé: | Medical Psychology, APH - Personalized Medicine, APH - Quality of Care, CCA - Cancer Treatment and Quality of Life |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Mammaplasty MEDLINE Breast Neoplasms Breast Oncology 03 medical and health sciences 0302 clinical medicine Breast cancer Surgical oncology Internal medicine medicine Humans Neoplasm Invasiveness 030212 general & internal medicine Diagnostic Errors Referral and Consultation Mastectomy Aged Retrospective Studies Aged 80 and over Observer Variation business.industry Second opinion Cancer Retrospective cohort study Middle Aged medicine.disease Prognosis Combined Modality Therapy Neoadjuvant Therapy Oncology 030220 oncology & carcinogenesis Surgery Female business Breast reconstruction Follow-Up Studies |
| Zdroj: | Annals of Surgical Oncology Annals of surgical oncology, 26(13), 4355-4363. Springer New York |
| ISSN: | 1534-4681 1068-9265 |
| Popis: | Background Breast cancer care is becoming increasingly complex, and patients with breast cancer are increasingly aware of the different treatment options, resulting in requests for second opinions (SOs). The current study investigates the impact of breast cancer SOs on final diagnosis and treatment in the Netherlands Cancer Institute (NCI) using a newly designed Breast Cancer Second Opinion (BCSO) classification system. Methods Patients who visited the NCI for an SO between October 2015 and September 2016 were included. Demographics, diagnostics, and treatment proposals were compared between first and SO. Discrepancy was categorized using our BCSO classification system, categorizing SOs into (1) noncomparable, (2) identical, and (3) minor or (4) major discrepancy. Results The majority of SOs (n = 591) were patient initiated (90.7%). A total of 121 patients underwent treatment prior to their SO, leaving 470 patients for assessment of discrepancies according to our BCSO classification system. More than 45% of these SOs resulted in at least one discrepancy, with comparable rates for physician- and patient-initiated SOs (42.5% vs. 45.6%, p = 0.708). Significantly more discrepancies were observed in patients with additional imaging (51.3% vs. 37.2%, p = 0.002) and biopsies (53.7% vs. 40.3%, p = 0.005). Almost 60% of all discrepancies were categorized as major (neoadjuvant systemic treatment instead of primary surgery, breast-conserving surgery instead of mastectomy, and proposing postmastectomy immediate breast reconstruction). Conclusions Our findings show substantial differences in diagnostic and treatment options in breast cancer patients visiting the Netherlands Cancer Institute for an SO, thereby emphasizing more consensus for the indications of these treatment modalities. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink