Navigation Links
Breast Cancer Outcome: Your Doctor Matters
Date:1/7/2011

By Kathleen Doheny
HealthDay Reporter

FRIDAY, Jan. 7 (HealthDay News) -- How doctors choose to treat their breast cancer patients -- and whether those treatment choices follow established recommendations -- may play a larger role in whether a cancer returns than experts have believed.

In a new analysis looking at 994 women with ductal carcinoma in situ, the most common type of noninvasive breast cancer, researchers found treatment variations from surgeon to surgeon are significant, and may account for up to 30 percent of recurrences.

"Treatment variation is a troubling but well-known phenomenon in health care," said study author Andrew W. Dick, a researcher at RAND Corp. in Pittsburgh. The report is published online Jan. 3 and in the Jan. 19 print issue of the Journal of the National Cancer Institute.

"The reason it is surprising in this case is that the variation is quite large, and related to factors that are very important in health outcomes," Dick said.

Those factors include having "negative margins" -- meaning that cancer cells are more than 2 millimeters away from the removed tissue's edge -- and getting radiation therapy after breast-conserving surgery.

The variation by surgeon in treatments accounted for 15 percent to 35 percent of cancer occurring in the opposite breast in the next five years and 13 percent to 30 percent of recurrences over 10 years, the investigators found.

The study is well done, said Beth Virnig, a professor of health policy and management at the University of Minnesota School of Public Health and co-director of the Cancer Outcomes and Survivorship Program at the university's Masonic Cancer Center.

She co-wrote an editorial to accompany the study.

"They basically said, after taking into account all this stuff that matters -- how big the tumor is, its grade and which treatment -- it turns out a third of how the patient does is due to their physician," she said.

While Virnig is not surprised at the variations in treatments, the amount of variation surprised her.

The findings are complex, she said, and so many factors determine outcome that there is no simple way to guarantee a woman has the best possible doctor and treatment.

One solution, Virnig said in her editorial, is to develop a kind of scoring system for breast cancer surgeons. But she acknowledges that this may not be feasible.

Meanwhile, she suggested that women can boost the odds of getting optimal treatment by asking their surgeon how many procedures the doctor does -- with more being better, though she can't provide a "good enough" number. "Many studies, but not all, show teaching institutions are better" when it comes to breast cancer treatments, she said.

If a scoring system were developed, said Dick, "I would like the system to evolve in such a way that the consumer doesn't have to be the fully informed expert."

Meanwhile, he said, women facing breast cancer should get their doctors' views on radiation therapy after breast-conserving surgery and the importance of negative margins -- both of which are associated with a lower risk of recurrence.

More information

For more on breast cancer, visit the U.S. National Cancer Institute.

SOURCES: Beth Virnig, Ph.D., M.P.H., professor, health policy and management, University of Minnesota School of Public Health, and co-director, Cancer Outcomes and Survivorship Program, University of Minnesota Masonic Cancer Center, Minneapolis; Andrew W. Dick, Ph.D., researcher, RAND Corp., Pittsburgh; Jan. 3, 2011, Journal of the National Cancer Institute, online


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Paxil Blocks Tamoxifen, Lowers Survival Odds Against Breast Cancer
2. Low forms of cyclin E reduce breast cancer drugs effectiveness
3. Racial disparities persist in the diagnosis of advanced breast cancer and colon cancer in the U.S.
4. For Some Breast Cancer Patients, Shorter Radiation Works Well
5. Short-term radiation therapy successful on breast cancer
6. Few Women at High Risk for Breast Cancer Take Tamoxifen
7. Hormone May Prevent Aggressive Breast Cancer
8. MSU researcher linking breast cancer patients with alternative therapies
9. MRI May Not Add Value to Routine Breast Cancer Care
10. Breast Cancer Stats Differ Racially Despite Similar Mammogram Rates
11. Businesses Rally Big Efforts to Benefit the Susan G. Komen Phoenix Affiliates Fight Against Breast Cancer
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Breast Cancer Outcome: Your Doctor Matters
(Date:3/27/2017)... ... 27, 2017 , ... The Association of Healthcare and Value ... their first Northeast Regional AHVAP Meeting. For 2017, Dr. Hayes will provide the ... value analysis professionals have a ‘seat at the table’ with clinical committees when ...
(Date:3/27/2017)... ... March 27, 2017 , ... Sodium determination is consistently becoming ... require expert user knowledge. In a live webinar on April 11th and October ... highly accurate, determination of sodium. , It has long been known that too ...
(Date:3/27/2017)... Fla. (PRWEB) , ... March 27, 2017 , ... ... overdose deaths soared 167%,(1) with opioids alone responsible for over 33,000 of the ... McCarty has sponsored Assembly Bill (AB) 1512, which proposes a tax on prescription ...
(Date:3/25/2017)... ... ... Getting earned media coverage meaningful for Garden Media Group's clients is the ... Garden Media aims to provide material helpful to clients’ goals and bottom lines. By ... messages to gain coveted media placements, Garden Media wows clients year-round. , Here ...
(Date:3/24/2017)... ... March 24, 2017 , ... ... will spark a conversation on the current obstacles facing infection prevention and offer ... preventable deaths caused by these infections. , The print component of “Fighting ...
Breaking Medicine News(10 mins):
(Date:3/27/2017)... March 27, 2017  PhaseRx, Inc. (NASDAQ: PZRX), ... inherited liver diseases in children, today reported financial ... ended December 31, 2016 and provided an update ... continued to make progress during the fourth quarter ... from our non-human primate safety study, and with our ...
(Date:3/24/2017)... Research and Markets has announced the ... report to their offering. ... The Cell Therapy Manufacturing Market, 2017-2027 report ... cell therapy manufacturing and focuses both on contract manufacturers and ... anticipated to emerge as viable alternatives to conventional treatment options. ...
(Date:3/24/2017)... , March 24, 2017  Zymo ... company, and Hamilton Robotics, Inc., who designs, ... an ongoing collaboration that teams Zymo Research,s ... RNA and DNA extraction products with Hamilton,s ... created optimized methods for microbiomics and RNA ...
Breaking Medicine Technology: