Sylvester Comprehensive Cancer Center

UM/Sylvester Physician-Researchers Find Many Community Hospitals May Be Under Treating Breast Cancer

08.10.2008

Community hospitals may under treat patients with advanced breast cancer known as infiltrating ductal carcinoma, according to a study led by two researchers at the University of Miami Sylvester Comprehensive Cancer Center. Leonidas G. Koniaris, M.D., associate professor of surgical oncology, and Judith Hurley, M.D., associate professor of clinical medicine and member of the Breast Cancer Site Disease Group published their findings in the August issue of the Annals of Surgery.

The study looked at all hospitals in Florida, identifying more than 28,000 cases of infiltrating ductal carcinoma over six years. In analyzing those cases, Koniaris, Hurley and four other researchers found that community hospitals were less likely to provide patients with important life-extending therapies such as chemotherapy or hormonal therapy compared to teaching hospitals.

These differences in treatment resulted in significant differences in survival for patients with more advanced breast cancers. “In advanced cases, those other therapies become critical in maximizing the cure for that patient,” says Koniaris.

This study found that many community hospitals are failing to give all the available treatments that teaching hospitals provide. The disparity in outcome is particularly evident in cases of advanced cancer. Both breast-conserving surgery and multimodality therapy were most frequently administered at teaching hospitals. Hurley points out that physicians “see higher risk patients in a university hospital, more young women, more poor women and harder to treat tumors. We are used to bringing the entire arsenal to bear on our patients’ care.”

Koniaris hopes the study leads to change. “Community hospitals that are treating women with breast cancer need to implement ways to make sure patients don’t fall through cracks in the system,” he said. “They should be provided the options to benefit from all available treatments.”

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