Identification of knowledge translation opportunities in the treatment of locally advanced breast cancer: Results of a national survey of physicians.

Authors

null

Yanchini Rajmohan

BC Cancer Agency, Vancouver, BC, Canada

Yanchini Rajmohan , Robyn Leonard , Sophie Hogeveen , Jalal Ebrahim , Dolly Han , Audrey Wong , Jean-Francois Boileau , Sonal Gandhi , Justin Lee , Robert Edward Dinniwell , Muriel Brackstone , Christine E. Simmons

Organizations

BC Cancer Agency, Vancouver, BC, Canada, BC Cancer Agency, Toronto, ON, Canada, St. Michael's Hospital, Toronto, ON, Canada, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada, Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, Princess Margaret Hospital, Toronto, ON, Canada, London Health Sciences Centre, London, ON, Canada

Research Funding

No funding sources reported

Background: Locally advanced breast cancer (LABC) accounts for only 10% of all breast cancers. While several guidelines and consensus statements exist, whether the current practice reflects these guidelines is unclear. We sought to survey the oncologists in Canada to assess current practice patterns and identify areas of targeted knowledge translation interventions (KTIs) in the treatment of LABC. Methods: 426 Canadian oncologists were surveyed with a 29 item survey-tool. They were subdivided into LABC experts (n=83) and non-experts (n=343). Physicians were removed from the survey if they identified that they were not involved in the treatment of breast cancer. The survey included demographic information as well as questions as to the current practice patterns utilized in the pathway of care for LABC patients. Level of discordance was calculated between the expert and non-expert responses using a z test. Results: 139 responses were obtained (48% response rate) from the non-experts and 51 responses were obtained from the experts (61% response rate). Areas of discordance in expert and non-expert survey included: frequency of clinical assessment during neoadjuvant therapy, methods for clinical assessment, radiographic re-evaluation post therapy, and assessment of receptor status (see Table). Conclusions: Several areas have been identified as targets for KTIs that may help to improve the quality and consistency of care of patients with LABC in Canada and may also have implications for improvements in resource utilization.

Question Expert
response
Non-expert
response
Level of
disconcordance
Response to neoadjuvant therapy should be assessed at each cycle 100% 76% 24% p = 0.0003
Response to NAT should be assessed by tape measure/caliper 96% 69% 31% p = 0.0003
Radiographic re-assessment should be done after NAT in all patients 0% 23% 23% p = 0.0003
ER/PR should be tested on core and only re-tested on final pathology
if initially negative/low positive
100% 28% 72% p = < 0.0001
HER2 should be tested on core and only re-tested on final pathology
if initially negative/low positive
93% 27% 66% p = < 0.0001

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Health Services Research

Track

Health Services Research

Sub Track

Outcomes and Quality of Care

Citation

J Clin Oncol 31, 2013 (suppl; abstr 6585)

DOI

10.1200/jco.2013.31.15_suppl.6585

Abstract #

6585

Poster Bd #

17A

Abstract Disclosures