Guidelines unmet: Assessing gaps in breast cancer survivorship care.

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.