Background
Methods
Selection of Physicians
Survey Instrument
Data Collection
Statistical Analysis
Characteristics, practices, guidelines
|
N
| None | A Few (<20%) | Several | Most (>90%) |
---|---|---|---|---|---|
% * |
% * |
% * |
% * | ||
Race/Ethnicity of patients treated over last 2 years | |||||
Non-Hispanic White | 75 | 1.3 | 9.3 | 60.0 | 29.3 |
Hispanic | 76 | 6.6 | 31.6 | 60.5 | 1.3 |
African American/Black | 77 | 9.1 | 52.0 | 39.0 | 0.0 |
Asian/Pacific Islander | 78 | 1.3 | 21.8 | 65.4 | 11.5 |
Patient decision-making preferences for treatment | |||||
Patient alone | 76 | 18.4 | 51.3 | 17.1 | 13.2 |
Patient with physician input | 78 | 0.0 | 10.3 | 39.7 | 50.0 |
Shared decision | 78 | 0.0 | 15.4 | 38.5 | 46.2 |
Physician with patient input | 76 | 13.2 | 60.5 | 21.0 | 5.3 |
Physician alone | 77 | 45.4 | 42.9 | 11.7 | 0.0 |
Hospital has facility-specific clinical practice guidelines (CPG) for patients | Yes | No | |||
80 | 27.5 | 72.5 | |||
Number of patients for whom physicians employ these CPG (among practices with CPGs, N = 23) | 23 | 0.0 | 8.7 | 4.4 | 87.0 |
Number of stage I and II breast cancer patients treated with MRM | 74 | 1.4 | 68.9 | 25.7 | 4.0 |
Physician perspective
|
% indicating "yes" * |
---|---|
Most important factors for stage I and II patients treated with MRM over last 2 years | |
Presence of multifocal or multicentric disease | 86.2 |
Tumor size | 71.2 |
Patient's attitude toward preserving the breast | 66.2 |
Breast size | 50.0 |
Age | 28.8 |
Location of tumor | 25.0 |
Patient's ability/willingness to travel to receive adjuvant radiation therapy | 22.5 |
Family history | 18.8 |
Cosmetic result | 17.5 |
Adverse effects/outcome | 6.2 |
Most important factors for stage I and II patients treated with BCT over last 2 years | |
Patient's attitude toward preserving the breast | 87.5 |
Tumor size | 77.5 |
Cosmetic result | 73.8 |
Breast size | 55.0 |
Patient's ability/willingness to travel to receive adjuvant radiation therapy | 38.8 |
Presence of multifocal or multicentric disease | 32.5 |
Age | 30.0 |
Location of tumor | 22.5 |
Adverse effects/outcome | 7.5 |
Family history | 6.2 |
Reasons why Asian subgroups are more likely to get MRM over BCT | |
Patient's attitude toward preserving the breast | 52.5 |
Breast size | 25.0 |
Age | 11.2 |
Patient's ability/willingness to travel to receive adjuvant radiation therapy | 10.0 |
Tumor size | 8.8 |
Adverse effects/outcome | 8.8 |
Cosmetic result | 7.5 |
Presence of multifocal or multicentric disease | 6.2 |
Location of tumor | 5.0 |
Family history | 2.5 |
Don't know | 17.5 |
Other | 18.8 |
Cultural factors | 6.2 |
Fear | 6.2 |
Results
Characteristic
|
n
|
% * |
---|---|---|
Gender | ||
Male | 53 | 66.2 |
Female | 27 | 33.8 |
Age (years) | ||
Under 40 | 11 | 13.8 |
40–49 | 22 | 27.5 |
50–59 | 30 | 37.5 |
60 and over | 17 | 21.2 |
Race/Ethnicity | ||
Asian | 26 | 32.5 |
Non-Asian | 54 | 67.5 |
Country of Origin | ||
USA | 58 | 72.5 |
Not USA | 22 | 27.5 |
Age Immigrated to US | ||
US Born | 58 | 72.5 |
<18 yrs old | 10 | 12.5 |
18+ yrs old | 12 | 15.0 |
Foreign Language Fluency | ||
English only | 47 | 58.8 |
Speaks more than English | 33 | 41.2 |
Discussed treatment in foreign language | ||
Yes | 51 | 63.8 |
No | 23 | 28.8 |
Residency specialty | ||
Medicine/Family | 17 | 21.2 |
General Surgery | 48 | 60.0 |
Radiation Oncology | 14 | 17.5 |
Fellowship specialty | ||
Breast or Oncology | 28 | 35.0 |
Other specialty | 13 | 16.2 |
None | 39 | 48.8 |