Since breast cancer diagnosis and treatment requires access to the knowledge and skill of a variety of professionals, as well as various types of specialized equipment and facilities, it makes sense that the quality of care might vary depending on where treatment is received.
The best care involves the services of many skilled professionals, treatment that conforms to best practices and is based on recent research, a concerted effort to protect patients from harmful side effects such as lymphedema and cardiomyopathy, a minimum of treatment delays, active and effective quality assurance systems, as well as the availability of genetic testing and counseling, psychological support, and evidence-based complementary medicine. It has long been assumed that care at a well regarded breast cancer center is superior to that available at community hospitals, however evidence of the impact on breast cancer survival has been lacking. Now a new study has reported that long-term breast cancer survivors treated at a major cancer center had better outcomes than those who were initially treated elsewhere.
Latest research finds outcomes may be better at major cancer center
The retrospective study referenced at the beginning of this news story was designed to investigate differences in long-term outcomes of survivors according to the location of their initial breast cancer treatment. To conduct the study, the authors examined the records of women diagnosed with invasive early-stage breast cancer who survived without any type of breast cancer relapse for at least five years after diagnosis. All of the women were eventually followed and treated at the University of Texas MD Anderson Cancer Center, a highly regarded cancer center. However, some of the women had undergone their initial treatment elsewhere. Initial treatment location was designated either as MD Anderson (MDA-treated) or other (OTH-treated). All of the women were seen at The University of Texas MD Anderson Cancer Center during the period January 1997 through August 2008. The study included 5,091 women (with a median follow-up period of 8.6 years), of whom 89.1% were MDA-treated.
The 10-year overall survival was 90.9% for women in the MDA-treated group compared to 74.3% for women in the OTH-treated group. The 10-year recurrence-free survival was 88.4% for the MDA-treated group compared to 49.8% in the OTH-treated group. Similarly, the 10-year distant relapse-free survival rate was 89.0% for the MDA-treated group compared to 52.7% in the OTH-treated group. Further analysis determined that women in the OTH-group were over five times more likely to experience a breast cancer relapse as those in the MDA-treated group. The authors conclude that long-term breast cancer survivors who started their treatment at MD Anderson had better outcomes, indicating that location of initial treatment could influence survival. These results have limitations common retrospective studies, according to the authors. For example, other unmeasured variables may be associated with worse prognosis.