Compliance differences between patients with breast cancer in university and county hospitals

Ian Komenaka*, Robert Pennington, Bryan Schneider, Chiu Hsieh Hsu, Laura Norton, Susan Clare, Noelia Zork, Robert Goulet

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: Compliance with recommended breast cancer treatments outside the context of a clinical trial differs from that in study populations. The purpose of this study was to examine differences in compliance of breast cancer treatments. Patients and Methods: We conducted a retrospective review of 529 patients treated at 2 teaching hospitals in the same city from 2003 to 2006. Compliance with adjuvant therapy recommendations and choice of breast-conserving operations were compared between a university hospital (UH) and a county hospital (CH). Results: The 2 populations demonstrated similar rates of breast conservation (72% vs. 69%). Although use of radiation therapy at the CH was acceptable (82%), patients at the UH were more likely to undergo radiation therapy (95%). The use of hormone therapy was similar at the UH and the CH (> 93%). Patients were more likely to follow physician recommendations for adjuvant chemotherapy at the UH (89%) compared with the CH (70%; P =.0005). Univariate analysis revealed that patient age, tumor size, stage, grade, and estrogen receptor status were all significant predictors of patient compliance with chemotherapy. Preoperative chemotherapy was a strong predictor of patient compliance with chemotherapy (P <.0001). In multivariate analysis, all of the factors predictive of patient compliance in univariate analysis remained significant except tumor grade. Conclusion: Preoperative chemotherapy appeared to increase compliance compared with adjuvant chemotherapy in the CH population. Compared with national standards, breast-conserving operations and radiation therapy compliance can be accomplished in an acceptable percentage of underinsured patients.

Original languageEnglish (US)
Pages (from-to)385-391
Number of pages7
JournalClinical Breast Cancer
Volume10
Issue number5
DOIs
StatePublished - Oct 1 2010

Keywords

  • Chemoprevention
  • Preoperative chemotherapy
  • Radiation therapy
  • Underinsured

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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