%0 PDF %T Timeliness and acceptance of recommended treatment in newly diagnosed breast cancer patients %A Dong, Jinghui. %D 2017-09-05T11:33:02.844-04:00 %8 2017-09-05 %R http://localhost/files/5d86pb668 %X Abstract: Breast cancer is the most common cancer in women and it is the second leading cause of cancer-related death in women in the United States. Although evidence-based recommendations for breast cancer care are well established, scant literature has documented patients' acceptance of recommended treatments. Disease and non-disease factors associated with non-acceptance remain unclear. Non-acceptance of recommended treatments can result in delayed initiation of effective treatment and failure to complete planned treatment. Both are known to be associated with a higher recurrence rate and may be reasons for disparities in breast cancer related survival. This study aimed to develop a metric to evaluate timeliness and patients' acceptance of recommended treatment in newly diagnosed breast cancer patients and to identify factors associated with meeting the quality benchmarks and patients' acceptance of the treatment. We reviewed 247 newly diagnosed breast cancer patients presented to Tufts Medical Center between January 2009 and June 2013. Of the patients who had surgery recommended as the first treatment, 80% (176/219) met the 45-day time-to-surgery benchmark with a median of 28 days to surgery. Of the patients who were stage I-III hormone receptor-positive, 92% (138/150) met the 365-day hormone therapy benchmark with a median of 145 days to hormone therapy. Analysis of acceptance by a single modality showed that 74% (17/23) of patients accepted neoadjuvant chemotherapy, 97% (232/240) accepted surgery, 83% (130/157) accepted radiation, 71% (85/119) accepted adjuvant chemotherapy, and 85% (155/183) accepted hormonal therapy. Overall, among 238 patients with known initiation of treatment, 61% accepted all recommended treatments, 21% rejected at least one treatment, and 18% had incomplete information. Multivariable regression showed that after adjusting for insurance, family history of breast cancer, prior history of breast cancer treatment, and comorbidity, older age (OR, 95%CI: 1.30, 1.12-1.53) and higher median household income by census tract (OR, 95%CI: 1.11, 1.03-1.19) were associated with meeting the 45-day time-to-surgery benchmark. These findings may help us identify patient populations at increased risk of delaying and/or not accepting recommended treatments and to inform the development of interventions and policies that are aimed toward improving timely and quality of breast cancer care.; Thesis (M.S.)--Tufts University, 2017.; Submitted to the Dept. of Clinical & Translational Science.; Advisor: Susan Parsons.; Committee: Karen Freund, and Farzad Noubary.; Keyword: Health care management. %[ 2022-10-12 %9 Text %~ Tufts Digital Library %W Institution