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Hospital organizational factors affect the use of immediate breast reconstruction after mastectomy for breast cancer in the Netherlands.
Breast 2017; 34:96-102B

Abstract

OBJECTIVES

Significant hospital variation in the use of immediate breast reconstruction (IBR) after mastectomy exists in the Netherlands. Aims of this study were to identify hospital organizational factors affecting the use of IBR after mastectomy for ductal carcinoma in situ (DCIS) or invasive breast cancer (BC) and to analyze whether these factors explain the variation.

MATERIALS AND METHODS

Patients with DCIS or primary invasive BC treated with mastectomy between 2011 and 2013 were selected from the national NABON Breast Cancer Audit. Hospital and organizational factors were collected with an online web-based survey. Regression analyses were performed to determine whether these factors accounted for the hospital variation.

RESULTS

In total, 78% (n = 72) of all Dutch hospitals participated in the survey. In these hospitals 16,471 female patients underwent a mastectomy for DCIS (n = 1,980) or invasive BC (n = 14,491) between 2011 and 2014. IBR was performed in 41% of patients with DCIS (hospital range 0-80%) and in 17% of patients with invasive BC (hospital range 0-62%). Hospital type, number of plastic surgeons available and attendance of a plastic surgeon at the MDT meeting increased IBR rates. For invasive BC, higher percentage of mastectomies and more weekly MDT meetings also significantly increased IBR rates. Adjusted data demonstrated decreased IBR rates for DCIS (average 35%, hospital range 0-49%) and invasive BC (average 15%, hospital range 0-18%).

CONCLUSION

Hospital organizational factors affect the use of IBR in the Netherlands. Although only partly explaining hospital variation, optimization of these factors could lead to less variation in IBR rates.

Authors+Show Affiliations

Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands; Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands; Scientific Committee NABON Breast Cancer Audit (NBCA), The Netherlands. Electronic address: K.Schreuder@iknl.nl.Scientific Committee NABON Breast Cancer Audit (NBCA), The Netherlands; Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.Scientific Committee NABON Breast Cancer Audit (NBCA), The Netherlands; Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.Scientific Committee NABON Breast Cancer Audit (NBCA), The Netherlands; Department of Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Scientific Committee NABON Breast Cancer Audit (NBCA), The Netherlands; Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute/University Medical Centre Rotterdam, Rotterdam, The Netherlands.Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands; Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands; Scientific Committee NABON Breast Cancer Audit (NBCA), The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28552797

Citation

Schreuder, K, et al. "Hospital Organizational Factors Affect the Use of Immediate Breast Reconstruction After Mastectomy for Breast Cancer in the Netherlands." Breast (Edinburgh, Scotland), vol. 34, 2017, pp. 96-102.
Schreuder K, van Bommel ACM, de Ligt KM, et al. Hospital organizational factors affect the use of immediate breast reconstruction after mastectomy for breast cancer in the Netherlands. Breast. 2017;34:96-102.
Schreuder, K., van Bommel, A. C. M., de Ligt, K. M., Maduro, J. H., Vrancken Peeters, M. T. F. D., Mureau, M. A. M., & Siesling, S. (2017). Hospital organizational factors affect the use of immediate breast reconstruction after mastectomy for breast cancer in the Netherlands. Breast (Edinburgh, Scotland), 34, pp. 96-102. doi:10.1016/j.breast.2017.05.011.
Schreuder K, et al. Hospital Organizational Factors Affect the Use of Immediate Breast Reconstruction After Mastectomy for Breast Cancer in the Netherlands. Breast. 2017;34:96-102. PubMed PMID: 28552797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospital organizational factors affect the use of immediate breast reconstruction after mastectomy for breast cancer in the Netherlands. AU - Schreuder,K, AU - van Bommel,A C M, AU - de Ligt,K M, AU - Maduro,J H, AU - Vrancken Peeters,M T F D, AU - Mureau,M A M, AU - Siesling,S, Y1 - 2017/05/25/ PY - 2017/02/23/received PY - 2017/05/17/revised PY - 2017/05/17/accepted PY - 2017/5/30/pubmed PY - 2018/4/11/medline PY - 2017/5/30/entrez KW - Audit KW - Breast cancer KW - Breast reconstruction KW - Hospital organizational factors KW - Hospital variation KW - Mastectomy SP - 96 EP - 102 JF - Breast (Edinburgh, Scotland) JO - Breast VL - 34 N2 - OBJECTIVES: Significant hospital variation in the use of immediate breast reconstruction (IBR) after mastectomy exists in the Netherlands. Aims of this study were to identify hospital organizational factors affecting the use of IBR after mastectomy for ductal carcinoma in situ (DCIS) or invasive breast cancer (BC) and to analyze whether these factors explain the variation. MATERIALS AND METHODS: Patients with DCIS or primary invasive BC treated with mastectomy between 2011 and 2013 were selected from the national NABON Breast Cancer Audit. Hospital and organizational factors were collected with an online web-based survey. Regression analyses were performed to determine whether these factors accounted for the hospital variation. RESULTS: In total, 78% (n = 72) of all Dutch hospitals participated in the survey. In these hospitals 16,471 female patients underwent a mastectomy for DCIS (n = 1,980) or invasive BC (n = 14,491) between 2011 and 2014. IBR was performed in 41% of patients with DCIS (hospital range 0-80%) and in 17% of patients with invasive BC (hospital range 0-62%). Hospital type, number of plastic surgeons available and attendance of a plastic surgeon at the MDT meeting increased IBR rates. For invasive BC, higher percentage of mastectomies and more weekly MDT meetings also significantly increased IBR rates. Adjusted data demonstrated decreased IBR rates for DCIS (average 35%, hospital range 0-49%) and invasive BC (average 15%, hospital range 0-18%). CONCLUSION: Hospital organizational factors affect the use of IBR in the Netherlands. Although only partly explaining hospital variation, optimization of these factors could lead to less variation in IBR rates. SN - 1532-3080 UR - https://www.unboundmedicine.com/medline/citation/28552797/Hospital_organizational_factors_affect_the_use_of_immediate_breast_reconstruction_after_mastectomy_for_breast_cancer_in_the_Netherlands_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0960-9776(17)30456-3 DB - PRIME DP - Unbound Medicine ER -