Are We Meeting Breast Cancer Survivor Preferences for Communication

and Wait Times?

Deanna J. Attai, MD FACS, Regina Hampton MD FACS, Alicia C. Staley BS MBA, Andrew Borgert PhD,

Jeffrey Landercasper MD FACS

Conflict of Interest

• No Disclosures

ASBrS Mastery of Breast Surgery Forum

Methods• IRB approved, de-identified survey• Cancer survivors• Posted--social media forums and in-person cancer support groups • 11 days

• Actual care versus preferred care

Modes of Communication for Test Results

Wait Times

Results of 1000 responding cancer survivors• 784 breast cancer survivors

• 89% Non-Hispanic White• 79% college educated• 97% online social media use• 84% community size – not rural

The most “advantaged” demographic group in public health literature• How well do we meet their preferences?

Mode of Communication of “New Cancer Diagnosis”

Face to Face Phone Other0%

10%

20%

30%

40%

50%

60%

39%

54%

7%

50%

34%

16%ActualPreferred

Mode of Communication

% p

atien

ts

p<0.0001

Wait Time for “New Cancer Diagnosis” ≤ 2 days

≤ 2 days0%

10%20%30%40%50%60%70%80%90%

40%

82%

ActualPreferred

Wait Time

% p

atien

ts

p<0.0001

Mode of Communication of “Radiology Results”

Phone0%5%

10%15%20%25%30%35%40%

27%

35%

ActualPreferred

Mode of Communication

% p

atien

ts

p<0.0001

Wait Time for “Radiology Results” ≤ 2 days

≤2 days0%

10%20%30%40%50%60%70%80%90%

51%

84%

ActualPreferred

Wait Time

% p

atien

ts

p<0.0001

Mode of Communication of “Blood Tests”

Phone Face to Face Electronic0%

10%

20%

30%

40%

50%

60%

19%

31%

49%

32%25%

43%

ActualPreferred

Mode of Communication

% p

atien

ts

p<0.0001

Wait Times for “Blood Tests” ≤ 2 days

≤ 2 days0%

10%20%30%40%50%60%70%80%90%

53%

79%

ActualPreferred

Wait Time

% p

atien

ts

p<0.0001

Other Findings• Preference for mode of communication depends on

type of test

• Face to face and telephone equally acceptable for radiology results

• Email, patient portal or other electronic preferred for blood test results

Limitations, Future Steps• Narrow demographic profile• Survey has not undergone reliability or validity testing

• Interrogation of other demographic groups is critical

Conclusions• Patient reported care outcomes must be sought if we want to identify gaps

in the quality of national healthcare

• Actual care did not meet preferred care expectations for any domain of communication or wait times!

• Patients prefer rapid results, ability to ask questions

• Ask patients about preferences for mode of communication• Evaluate system issues to best honor patient preferences

Acknowledgements• Dr. Susan Love Research Foundation• Seattle Cancer Care Alliance• Living Beyond Breast Cancer• Norma J Vinger Center for Breast Care• Gundersen Medical Foundation• Ms. Choua Vang