Background: In Canada, after completing their treatment at oncology centers in tertiary care facilities, most breast cancer patients are discharged and receive survivorship care from primary care providers (PCPs). Evidence-based guidelines exist to inform appropriate care for breast cancer survivor follow-up.
Objectives: This study analyzed the concordance of breast cancer survivorship follow-up care by PCPs with recommended guidelines at an academic Family Health Team (FHT) in Ottawa.
Design: Retrospective chart review of electronic medical records of rostered patients from FHT.
Methods: Data was extracted from the charts of 60 breast cancer survivors. Concordance of breast cancer survivorship care by PCPs with evidence-based guidelines was established in three key survivorship domains: surveillance for recurrence or new cancers, management of treatment side effects and preventative health.
Results: PCPs provide care concordant with guidelines only 20% of the time, with areas such as preventative care at 86.7% concordance far better than management of side effects at 58.3% and oncological surveillance at 38.3%. Care did not significantly differ by age at diagnosis.
Conclusion: These results highlight gaps in the current survivorship care delivery and function as a baseline for comparative analyses for future interventions to optimize survivorship follow-up care.
Keywords: breast cancer; primary care; survivorship; survivorship care plan.
Beyond treatment: How well are we caring for Breast Cancer Survivors?Are breast cancer survivors followed by family doctors getting appropriate care?Why was this study done?Following treatment for breast cancer in Canada, most patients move out of the cancer care system and receive their survivorship care from primary care providers (PCPs). Although specific guidelines exist to assist PCPs in caring for breast cancer survivors, it remains unclear how closely their practices align with these recommendations. This study aims to evaluate the adherence of PCPs to the established guidelines for breast cancer survivorship care.What did the researchers do?The research team reviewed the charts of breast cancer survivors in a large urban academic family health team. They looked specifically at how well the family doctors were following the guidelines in three categories: looking for new or recurrent cancers, managing the side effects of the breast cancer and its treatments, and preventative care.What did the researchers find?The results showed that adherence to the recommended guidelines for breast cancer survivorship care was only 20%. However, there were significant variations across different areas of care: preventative health services aligned with guidelines 86.7% of the time, management of treatment side effects was at 58.3%, and oncological surveillance was the lowest at 38.3%. The quality of care provided did not significantly differ based on the patients’ age at diagnosis.What do these findings mean?This study has identified important gaps in the survivorship care provided to breast cancer patients, underscoring the need for improvements in follow-up processes. By highlighting shortcomings in survivorship care, this study establishes a baseline for future research and interventions aimed at improving care for breast cancer survivors. Better adherence to guidelines can lead to improved health outcomes and stronger support for those adjusting to life after cancer treatment.