The Breast
Volume 19, Issue 4 , Pages 297-302 , August 2010

Challenges and economics of private breast cancer surgery practice

  • Lisa Bailey

      Affiliations

    • Bay Area Breast Surgeons, Inc., 3300 Webster Street, Suite 212, Oakland, CA 94609, USA
    • Medical Director, Carol Ann Read Breast Health Center, Alta Bates Summit Medical Director, 3100 Summit Street, Oakland, CA 94609, USA
    • Corresponding Author InformationBay Area Breast Surgeons, Inc., 3300 Webster Street, Suite 212, Oakland, CA 94609, USA. Tel.: +1 510 835 9900; fax: +1 510 835 9909.

References 

  1. Rose C, Stoval E, Ganz PA, Desch C, Hewitt M. Cancer quality alliance: blueprint for a better cancer system. CA Cancer J Clin. 2008;58:266–292
  2. La Fargue M, Coleman C. In search of excellence: exploring the economics of breast care. Semin Breast Dis. 2008;11:113–115
  3. National Quality Forum (NQF). NQF Endorsed Commission on Cancer (CoC) measures for quality of cancer care for breast and colorectal cancers. Available from: http://www.facs.org/cancer/qualitymeasures.html. [accessed February 20, 2010].
  4. The American Society of Breast Surgeons. Mastery of breast surgery pilot program. Available from: http://www.breastsurgeons.org/mastery/index.php [accessed December 15, 2009].
  5. McCahill LE, Privetts A, James T, et al. Quality measures for breast cancer surgery: initial validation of feasibility and assessment of variation among surgeons. Arch Surg. 2009;144:455–462
  6. Rutgers EJ. Guidelines to assure quality in breast cancer surgery. Eur J Surg Oncol. 2005;31:568–576
  7. Yermilov I, Maggard MA. Defining quality of care for breast cancer: clinical challenges. Semin Breast Dis. 2007;10:121–127
  8. Birido N, Geraghty JG. Quality control in breast cancer surgery. Eur J Surg Oncol. 2005;31:577–586
  9. Cady B. Interdisciplinary comprehensive breast tumor boards: their role in the comprehensive management of contemporary breast cancer. Semin Breast Dis. 2008;11:4–8
  10. Tabár L, Chen TH, Yen AM, Dean PB. Detection, diagnosis, and treatment of early breast cancer requires creative interdisciplinary teamwork. Semin Breast Dis. 2005;8:4–9
  11. Newman EA. Changes in surgical management resulting from case review at a breast cancer multidisciplinary tumor board. Cancer. 2006;107:2346–2351
  12. Pass HA, Klimberg SV, Copeland EM. Are “breast-focused” surgeons more competent?. Ann Surg Oncol. 2008;15:953–955
  13. Ritchie WP. Invited commentary: comment from American Board of Surgery. Surgery. 2002;131:205–209
  14. Dupont E, Cox C, Shivers S, et al. Learning curves and breast cancer lymphatic mapping: institutional volume index. J Surg Res. 2001;97:92–96
  15. Johnson JM, Orr RK, Moline SR. Institutional learning curve for sentinel node biopsy at a community teaching hospital. Am Surg. 2001;67:1030–1033
  16. Cox CE, Salud CJ, Cantor A, et al. Learning curves for breast cancer sentinel lymph node mapping based on surgical volume analysis. J Am Coll Surg. 2001;193:593–600
  17. Porter GA, McMulkin-Tait H. Practice patterns in breast cancer surgery: Canadian perspective. World J Surg. 2004;28:80–86
  18. Neuner JM, Gilligan MA, Sparapani R, Laud PW, Haggstrom D, Nattinger AB. Decentralization of breast cancer surgery in the United States. Cancer. 2004;101:1323–1329
  19. Waljee JF, Hawley S, Alderman AK, Morrow M, Katz SJ. Patient satisfaction with treatment of breast cancer: does surgeon specialization matter?. J Clin Oncol. 2007;25:3694–3698
  20. Luther SL, Studnicki J. Physician practice volume and alternative surgical treatment for breast cancer in Florida. Health Serv Res. 2001;36:166–179
  21. Mikeljevic SJ, Haward RA, Johnston C, Sainbury R, Forman D. Surgeon workload and survival from breast cancer. Br J Cancer. 2003;89:487–491
  22. Opatt D, Morrow M, Hawley S, Schwartz K, Janz NK, Katz SJ. Conflicts in decision-making for breast cancer surgery. Ann Surg Oncol. 2007;14:2463–2469
  23. Hershman DL, Buono D, Jacobson JS, et al. Surgeon characteristics and use of breast conservation surgery in women with early breast cancer. Ann Surg. 2009;249:828–833
  24. Richards MA, Wolfe CD, Tilling K, Barton J, Bourne HM, Gregory WM. Variation in the management and survival of women under 50 years with breast cancer in the South East Thames region. Br J Cancer. 1996;73:751–757
  25. Sainsbury R, Rider L, Smith A, MacAdam A The Yorkshire Breast Cancer Group. Does it matter where you live?: treatment variation for breast cancer in Yorkshire. Br J Cancer. 1995;71:1275–1278
  26. McKee MD, Cropp MD, Hyland A, Watroba N, Mckinley B, Edge SB. Provider case volume and outcome in the evaluation and treatment of patients with mammogram-detected breast carcinoma. Cancer. 2002;95:704–712
  27. Morrow M, Jagsi R, Alderman AK, et al. Surgeon recommendations and receipt of mastectomy for treatment of breast cancer. JAMA. 2009;302:1551–1556
  28. Hawley ST, Hofer TP, Janz NK, et al. Correlates of between-surgeon variation in breast cancer treatments. Med Care. 2006;44:609–616
  29. Nattinger AB, Goodwin JS. Geographic and hospital variation in the management of older women with breast cancer. Cancer Control. 1994;1:334–338
  30. Hiotis K, Ye W, Sposto R, Skinner KA. Predictors of breast conservation therapy: size is not all that matters. Cancer. 2005;103:892–899
  31. Nahabedian MY. Managing the opposite breast: contralateral symmetry procedures. Cancer J. 2008;14:258–263
  32. Regano S, Hernanz F, Ortega E, Redondo-Figuero C, Gomez-Fleitas M. Oncoplastic techniques extend breast-conserving surgery to patients with neoadjuvant chemotherapy response unfit for conventional techniques. World J Surg. 2009;33:2082–2086
  33. Kollias J, Davies G, Bochner MA, Gill PG. Clinical impact of oncoplastic surgery in a specialist breast practice. ANZ J Surg. 2008;78:225–226
  34. Alderman AK, Hawley ST, Waljee J, Morrow M, Katz SJ. Correlated of referral practices of general surgeons to plastic surgeons for mastectomy reconstruction. Cancer. 2007;109:1715–1720
  35. Hofer TP, Hawley ST, Katz SJ. Does it matter where you go for breast cancer surgery?. J Clin Oncol. 2009;27:15s;(suppl; abstr 6504)
  36. Scroen AT, Brenin DR. Clinical trial priorities among surgeons caring for breast cancer patients. Am J Surg. 2008;195:474–480
  37. Nattinger AB, Laud PW, Sparapani RA, Zhang X, Neuner JM, Gilligan MA. Exploring the surgeon volume outcome relationship among women with breast cancer. Arch Intern Med. 2007;167:1958–1963
  38. Chen CS, Liu TC, Lin HC, Lien YC. Does high surgeon and hospital surgical volume raise the five-year survival rate for breast cancer? a population-based study. Breast Cancer Res Treat. 2008;110:349–356
  39. Allgood PC, Bachmann MO. Effects of specialization on treatment and outcomes in screen-detected breast cancers in Wales: cohort study. Br J Cancer. 2006;94:36–42
  40. Zork NM, Komenaka IK, Pennington RE, et al. The effect of dedicated breast surgeons on the short-term outcomes in breast cancer. Ann Surg. 2008;248:280–285
  41. Hawley ST, Hofer TP, Janz NK, et al. Correlates of between-surgeon variation in breast cancer treatments. Med Care. 2006;44:607–608
  42. Gilligan MA, Neuner J, Zhang X, et al. Relationship between number of breast cancer operations performed and 5-year survival after treatment for early-stage breast cancer. Am J Public Health. 2007;97:539–544
  43. Gillis CR, Hole DJ. Survival outcome of care by specialist surgeons in breast cancer: a study of 3786 patients in the west of Scotland. BMJ. 1996;312:145–148
  44. Skinner KA, Helsper JT, Deapen D, et al. Breast cancer: do specialists make a difference?. Ann Surg Oncol. 2003;10:606–615
  45. Morris E, Haward RA, Gilthorpe MS, Craigs C, Forman D. The impact of the Calman-Hine report on the processes and outcomes of care for Yorkshire’s breast cancer patients. Ann Oncol. 2008;19:284–289
  46. Monaghan P, Murray L, Donnelly M, McCarron P, Spence R, Gavin A. Breast cancer services – a population-based study of service reorganization. J Public Health (Oxf). 2005;27(2):171–175
  47. Golledge J, Wiggins JE, Callam MJ. Effect of surgical subspecialization on breast cancer outcome. Br J Surg. 2000;87:1420–1425
  48. Kingsmore D, Hole D, Gillis C. Why does specialist treatment of breast cancer improve survival? The role of surgical management. Br J Cancer. 2004;90:1920–1925
  49. Kingsmore D, Ssemwogerere A, Hole D, Gillis C. Specialization and breast cancer survival in the screening era. Br J Cancer. 2003;88:1708–1712
  50. Hershman DL, Buaono D, McBride RB, et al. Surgeon characteristics and receipt of adjuvant radiotherapy in women with breast cancer. J Natl Cancer Inst. 2008;100:199–206
  51. McCarthy M, Datta P, Sherlaw-Johnson C, Coleman M, Rachet B. Is the performance of cancer services influenced more by hospital factors or by specialization?. J Public Health (Oxf). 2008;30:69–74
  52. Gort M, Broekhuis M, Otter R, Klazinga NS. Improvement of breast practice in early breast cancer: actionable surgeon and hospital factors. Breast Cancer Res Treat. 2007;102:219–226
  53. Katz SJ, Hofer TP, Hawley S, et al. Patterns and correlates of patient referral to surgeons for treatment of breast cancer. J Clin Oncol. 2007;25:271–276
  54. Guller U, Safford S, Pietrobon R, Heberer M, Oertli D, Jain NB. High hospital volume is associated with better outcomes for breast cancer surgery: analysis of 233,247 patients. World J Surg. 2005;29:994–999
  55. Bouche G, Migeot V, Mathoulin-Pelissier S, Salamon R, Ingrand P. Breast cancer surgery: do all patients want to go to high-volume hospitals?. Surgery. 2008;14:699–705
  56. Ma M, Bell J, Campbell S, Basmett I, Pollock A, Taylor I. Breast cancer management: is volume related to quality? Clinical Advisory Panel. Br J Cancer. 1997;75:1652–1659
  57. Staradub VL, Rademaker AW, Morrow M. Factors influencing outcomes for breast conservation therapy of mammographically detected malignancies. J Am Coll Surg. 2003;196:518–524
  58. Gilligan MA, Neuner J, Sparapani R, Laud PW, Nattinger AB. Surgeon characteristics and variation in treatment for early-stage breast cancer. Arch Surg. 2007;142:17–22
  59. Sainsbury R, Haward B, Rider L, Johnston C, Round C. Influence of clinician workload and patterns of treatment in survival from breast cancer. Lancet. 1995;345:1265–1270
  60. Katz SJ, Hawley ST, Morrow M Coordinating Cancer Care. Patient and practice management processes among surgeons who treat breast cancer. Med Care. 2010;48:45–51
  61. Keating NL, Kouri E, He Y, Weeks JC, Winer EP. Racial differences in definitive cancer therapy in older women: are they explained by the hospital where patients undergo surgery?. Med Care. 2009;47:765–773
  62. Bickell NA, Aufses AJ, Chassin MR. The quality of early-stage breast cancer care. Ann Surg. 2000;232:220–224
  63. Hand R, Sener S, Imperato J, Chmiel JS, Sylvester JA, Fremgen A. Hospital variables associate with quality of care for breast cancer patients. JAMA. 1991;266:3429–3434
  64. Hiotis K, Ye W, Sposto R, Goldberg J, Mukhi V, Skinner K. The importance of location in determining breast conservation rates. Am J Surg. 2005;190:18–22
  65. Anderson B, Kaufman C, Kiel K, Carlson C. Colloquium: ensuring optimal interdisciplinary breast care in the United States. American Society of Breast Disease. Available from: http://www.asbd.org/downloads/Colloquium/ASBD_Colloquium_Proceedings.pdf [accessed January 10, 2010].
  66. Calman K, Hine D. A policy framework for commissioning cancer services. A report by the expert advisory group on to the Chief Medical Officers of England and Wales; April 1995.
  67. Tataru D, Robinson D, Moller H, Davies E. Trends in the treatment of breast cancer on Southeast England following the introduction of national guidelines. J Public Health (Oxf). 2006;28:215–217
  68. Haward RA. The Calman-Hine report: a personal retrospective on the UK’s first comprehensive policy on cancer services. Lancet Oncol. 2006;794:336–346
  69. Rouse AM, Jooly K, Stevens AJ. Has Calman-Hine succeeded? Analysis of breast cancer procedure loads per consultant from before and after the Calman-Hine report. Breast. 2001;10:55–57
  70. Haward R, Amir Z, Borrill C, et al. Breast cancer teams: the impact of constitution, new cancer workload, and methods of operations on their effectiveness. Br J Cancer. 2003;89:15–22
  71. Brucker SY, Bamberg M, Jonat W, et al. Certification of breast centers in Germany: proof of concept for a prototypical example of quality assurance in multidisciplinary cancer. BMC Cancer. 2009;9:228
  72. Brucker SY, Schumacher C, Sohn C, Rezai M, Bamberg M, Wallwiener D Steering Committee. Benchmarking the quality of breast cancer care in a nationwide voluntary system: the first five-year results (2003–2007) from Germany as a proof of concept. BMC Cancer. 2008;8:358

PII: S0960-9776(10)00066-4

doi: 10.1016/j.breast.2010.03.012

The Breast
Volume 19, Issue 4 , Pages 297-302 , August 2010

Article Tools