Comprehensive breast center improves quality of care for breast reconstruction

November 03, 2014

November 3, 2014 - After opening a comprehensive breast center (CBC), one hospital achieved significant improvement in key measures of quality of care for women undergoing breast reconstruction, reports the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Centralized breast cancer care at CBCs can lead to more timely breast reconstruction for women undergoing breast cancer surgery, suggests the study by ASPS Member Surgeon Albert H. Chao, MD, and colleagues of The Ohio State University, Columbus. They write, "Access to breast reconstruction at our institution improved significantly after our CBC opened, with significant increases in internal referral rates and immediate reconstruction rates."

Transition to CBC Improves Processes of Care

The researchers assessed "process of care" outcomes related to breast reconstruction before and after their hospital transitioned to a CBC approach. Comprehensive breast centers seek to improve patient care and outcomes by assembling a group of highly specialized practitioners--oncologists, plastic and reconstructive surgeons, and other professionals--to provide coordinated breast cancer care. The study compared 614 women treated for breast cancer before the CBC transition and 750 women treated afterward.

Surgical oncologists (breast cancer surgeons) at the hospital saw about the same number of patients during both periods. However, after the CBC transition, patients were more likely to be referred to a plastic surgeon for breast reconstruction. The referral rate increased from about 27 percent to 46 percent.

Women treated in the CBC were also referred more promptly for breast reconstruction. "The time between surgical oncology consultation and plastic surgery consultation decreased from 10.5 days to 3.6 days," Dr Chao and coauthors write. The percentage of patients who saw that breast cancer surgeon and plastic surgeon on the same day increased from 6.5 percent before the CBC was opened, to 50 percent afterward.

Improved Access to Timely Breast Reconstruction

For women who underwent mastectomy, the CBC approach increased the rate of immediate breast reconstruction: from about 40 percent to over 52 percent. In this group, the time between the plastic surgery visit and mastectomy/breast reconstruction decreased from about 42 days to 30 days.

Rates of important types of complications after breast reconstruction surgery were about the same before and after the CBC approach.

Because long-term follow-up is needed to assess the oncologic outcomes of breast cancer (survival, etc), studies of the quality of care provided at CBCs have focused on processes of care. The new experience suggests that large hospitals transitioning to the CBC approach may be able to offer breast reconstruction to more patients, with shorter times to plastic surgery referral.

Dr Chao and coauthors write, "A new diagnosis of breast cancer can be distressing for a patient, and every day that passes between the time the diagnosis is made and the time treatment is administered can increase a patient's anxiety." In the CBC approach, breast reconstruction consultations for new patients were scheduled in the afternoon, to enable more patients to have their surgical oncology and plastic surgery visits on the same day.

The researchers also note that the CBC approach was "financially sustainable" for their hospital, even after the investment in resources devoted to breast reconstruction. Dr Chao and colleagues conclude, "In breast reconstruction, a comprehensive breast center improves processes of care, and underscores the importance of plastic surgery involvement within these centers."
-end-
Click here to read "Process Outcomes in Breast Reconstruction and the Impact of a Comprehensive Breast Center."

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About Plastic and Reconstructive Surgery

For more than 60 years, Plastic and Reconstructive Surgery®, has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at http://www.plasticsurgery.org or http://www.facebook.com/PlasticSurgeryASPS and http://www.twitter.com/ASPS_news.

About Wolters Kluwer Health

Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries worldwide, clinicians rely on Wolters Kluwer Health's market leading information-enabled tools and software solutions throughout their professional careers from training to research to practice. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical and UpToDate®.

Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2013 annual revenues of €3.6 billion ($4.7 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America.maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Wolters Kluwer is headquartered in Alphen aan den Rijn, the Netherlands. Its shares are quoted on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

Follow our official Twitter handle: @WKHealth.

Wolters Kluwer Health

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.