An assessment of neoadjuvant therapy for breast cancer and treatment wait times at the BC Cancer Agency Vancouver.

Authors

null

Rachel Adilman

BC Cancer Agency, Vancouver, BC, Canada

Rachel Adilman, Robyn Leonard, Zia Poonja, Christine E. Simmons

Organizations

BC Cancer Agency, Vancouver, BC, Canada

Research Funding

No funding sources reported

Background: Neoadjuvant therapy (NAT) is widely considered to be the standard of care for patients diagnosed with locally advanced breast cancer (LABC) or inflammatory breast cancer (IBC). NAT is also considered in patients with more aggressive subtypes (Her2+ or triple negative cancers). However, it remains unclear which patients are being considered for NAT, which patients are indeed receiving NAT, and how long the current wait times for chemotherapy and hormone therapy are in this patient population. This study was designed to characterize the breast cancer patients being referred to the BC Cancer Agency (BCCA) Vancouver’s NAT clinic, and to determine the average wait times for chemotherapy and hormone therapy in these patients. Methods: Between May 13th, 2013 and June 3rd, 2014, a total of 160 potential NAT candidates were seen at the BCCA Vancouver NAT clinic. Breast cancer characteristics and wait times for these patients were assessed prospectively using a secure database. Results: Of these 160 patients, 119 (74%) actually received NAT; 76.7% of these were deemed LABC patients (clinical stage IIB or III), and 6% were “window of opportunity” (WOP) patients (those considered for NAT due to long surgical wait times). NAT patient receptor status differed significantly from the receptor statuses of patients who did not receive NAT (p=0.006), with Her2+ and triple negative breast cancer patients being most likely to receive NAT. Seventy-eight percent of ER+Her2+, 86% of ER-Her2+, 67% of ER+Her2-, and 80% of triple negative patients received NAT. A total of 4 patients (2.5%) presented in clinic with metastatic disease and thus were not considered for NAT. The average wait time between when a patient was referred to the BCCA and when they commenced chemotherapy was 18.1 days (median: 16), while the average wait time to receive hormone therapy alone was 12.3 days (median: 10). Conclusions: These findings suggest a need to expedite screening and care for these high-risk breast cancer patients in order to characterize and treat the disease neoadjuvantly before it has metastasized. Strategies to reduce wait times in this breast cancer population are being further assessed.

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Abstract Details

Meeting

2014 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

General Poster Session B: Cost, Value, and Policy in Quality and Practice of Quality

Track

Practice of Quality,Cost, Value, and Policy in Quality

Sub Track

Learning from Projects Done in a Health System

Citation

J Clin Oncol 32, 2014 (suppl 30; abstr 140)

DOI

10.1200/jco.2014.32.30_suppl.140

Abstract #

140

Poster Bd #

F8

Abstract Disclosures