SpringerLink
Log in

Patient-reported observations on medical procedure timeliness (PROMPT) in breast cancer: a qualitative study

  • Research
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Timeliness of care is an important healthcare outcome measure. The objective of this study was to explore patient perspectives on the timeliness of breast cancer diagnosis and treatment at accredited breast cancer centers.

Methods

In this qualitative study, 1 hour virtual interviews were conducted with participants 18–75 years old who were diagnosed and treated for stage 0–III breast cancer at a National Accreditation Program for Breast Centers facility from 2018 to 2022. Thematic analysis was used to identify key themes of participant experiences.

Results

Twenty-eight participants were interviewed. Two thematic domains were identified: etiologies of expedited or delayed care and the impact of delayed or expedited care on patients. Within these domains, multiple themes emerged. For etiologies of expedited or delayed care, participants discussed (1) the effect of scheduling appointments, (2) the COVID-19 pandemic, (3) dissatisfaction with the timeline for various parts of the diagnostic workup, and (4) delays related to patient factors, including socioeconomic status. For the impact of expedited or delayed care, patients discussed (1) the emotional and mental impact of waiting, (2) the importance of communication and clear expectations, and (3) the impact of electronic health portals. Patients desired each care interval (e.g., the time from mammogram to breast biopsy) to be approximately 7 days, with longer intervals sometimes preferred prior to surgery.

Conclusion

These patient interviews identify areas of delay and provide patient-centered, actionable items to improve the timeliness of breast cancer care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to patient privacy but de-identified information is available from the corresponding author on reasonable request.

Abbreviations

NAPBC:

National accreditation program for breast centers

PROMPT:

Patient-reported observations on medical procedure timeliness

References

  1. Khorana AA, Tullio K, Elson P et al (2019) Time to initial cancer treatment in the United States and association with survival over time: an observational study. PLoS ONE 14(3):e0213209

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Mariella M, Kimbrough CW, McMasters KM, Ajkay N (2018) Longer time intervals from diagnosis to surgical treatment in breast cancer: associated factors and survival impact. Am Surg 84(1):63–70

    Article  PubMed  Google Scholar 

  3. Bleicher RJ, Ruth K, Sigurdson ER et al (2012) Preoperative delays in the US Medicare population with breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 30(36):4485–4492

    Article  Google Scholar 

  4. Al-Masri M, Aljalabneh B, Al-Najjar H, Al-Shamaileh T (2021) Effect of time to breast cancer surgery after neoadjuvant chemotherapy on survival outcomes. Breast Cancer Res Treat 186(1):7–13

    Article  PubMed  Google Scholar 

  5. Bleicher RJ, Ruth K, Sigurdson ER et al (2016) Time to surgery and breast cancer survival in the United States. JAMA Oncol 2(3):330–339

    Article  PubMed  PubMed Central  Google Scholar 

  6. Pratt D, Burneikis T, Tu C, Grobmyer S (2021) Time to completion of breast cancer treatment and survival. Ann Surg Oncol 28(13):8600–8608

    Article  PubMed  Google Scholar 

  7. Pineault P (2007) Breast cancer screening: women’s experiences of waiting for further testing. Oncol Nurs Forum 34(4):847–853

    Article  PubMed  Google Scholar 

  8. Hayes Balmadrid MA, Shelby RA, Wren AA et al (2017) Anxiety prior to breast biopsy: relationships with length of time from breast biopsy recommendation to biopsy procedure and psychosocial factors. J Health Psychol 22(5):561–571

    Article  PubMed  Google Scholar 

  9. Landercasper J, Linebarger JH, Ellis RL et al (2010) A quality review of the timeliness of breast cancer diagnosis and treatment in an integrated breast center. J Am Coll Surg 210(4):449–455

    Article  PubMed  Google Scholar 

  10. Attai DJ, Hampton R, Staley AC, Borgert A, Landercasper J (2016) What do patients prefer? Understanding patient perspectives on receiving a new breast cancer diagnosis. Ann Surg Oncol 23(10):3182–3189

    Article  PubMed  Google Scholar 

  11. Brown CM, Kanu C, Richards KM, Stevens L, Sasane R, McAneny B (2022) Exploring access to care from the perspective of patients with breast cancer: a qualitative study. Cancer Med 11(12):2455–2466

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hennink MM, Kaiser BN, Marconi VC (2017) Code saturation versus meaning saturation: how many interviews are enough? Qual Health Res 27(4):591–608

    Article  PubMed  Google Scholar 

  13. Glaser B, Strauss A (2017) Discovery of grounded theory: strategies for qualitative research. Routledge, Milton Park

    Book  Google Scholar 

  14. Hislop TG, Harris SR, Jackson J et al (2002) Satisfaction and anxiety for women during investigation of an abnormal screening mammogram. Breast Cancer Res Treat 76(3):245–254

    Article  PubMed  Google Scholar 

  15. Frosch ZAK, Jacobs LM, O’Brien CS et al (2023) “Cancer’s a demon”: a qualitative study of fear and multilevel factors contributing to cancer treatment delays. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 32(1):13

    Google Scholar 

  16. Baliski C, McGahan CE, Liberto CM et al (2014) Influence of nurse navigation on wait times for breast cancer care in a Canadian regional cancer center. Am J Surg 207(5):686–691

    Article  PubMed  Google Scholar 

  17. Haideri NA, Moormeier JA (2011) Impact of patient navigation from diagnosis to treatment in an urban safety net breast cancer population. J Cancer 2:467–473

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ell K, Vourlekis B, Lee PJ, **e B (2007) Patient navigation and case management following an abnormal mammogram: a randomized clinical trial. Prev Med 44(1):26–33

    Article  PubMed  Google Scholar 

  19. Koh C, Nelson JM, Cook PF (2011) Evaluation of a patient navigation program. Clin J Oncol Nurs 15(1):41–48

    Article  PubMed  Google Scholar 

  20. Ferrante JM, Chen PH, Kim S (2008) The effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: a randomized controlled trial. J Urban Health Bull N Y Acad Med 85(1):114–124

    Google Scholar 

  21. Ramirez A, Perez-Stable E, Penedo F et al (2014) Reducing time-to-treatment in underserved Latinas with breast cancer: the six cities study. Cancer 120(5):752–760

    Article  PubMed  Google Scholar 

  22. Khanna AS, Brickman B, Cronin M et al (2022) Patient navigation can improve breast cancer outcomes among African American women in Chicago: insights from a modeling study. J Urban Health Bull N Y Acad Med 99(5):813–828

    Google Scholar 

  23. Centers for Medicare & Medicaid Services. CMS finalizes physician payment rule that advances health equity. https://www.cms.gov/newsroom/press-releases/cms-finalizes-physician-payment-rule-advances-health-equity

  24. Shields CG, Ziner KW, Bourff SA et al (2010) An intervention to improve communication between breast cancer survivors and their physicians. J Psychosoc Oncol 28(6):610–629

    Article  PubMed  PubMed Central  Google Scholar 

  25. Miller LS, Shelby RA, Balmadrid MH et al (2016) Patient anxiety before and immediately after imaging-guided breast biopsy procedures: impact of radiologist-patient communication. J Am Coll Radiol JACR 13(11S):e62–e71

    Article  PubMed  Google Scholar 

  26. Zhang M, Sun S, Mesurolle B (2017) The impact of pre-operative breast MRI on surgical waiting time. PLoS ONE 12(1):e0169756

    Article  PubMed  PubMed Central  Google Scholar 

  27. Chagpar AB, Howard-McNatt M, Chiba A et al (2022) Factors affecting time to surgery in breast cancer patients. Am Surg 88(4):648–652

    Article  PubMed  Google Scholar 

  28. Wu V, Chichura AM, Dickard J, Turner C, Al-Hilli Z (2023) Perioperative genetic testing and time to surgery in patients with breast cancer. Surgery S0039–6060(23):00611–00616

    Google Scholar 

  29. Beer M, Allison H, Fisher C, Fan B (2022) Second opinions in breast cancer surgery: what have we learned? Cureus. 14(10):e30180

    PubMed  PubMed Central  Google Scholar 

  30. Kurian AW, Friese CR, Bondarenko I et al (2017) Second opinions from medical oncologists for early-stage breast cancer: prevalence, correlates, and consequences. JAMA Oncol 3(3):391–397

    Article  PubMed  PubMed Central  Google Scholar 

  31. Garcia D, Spruill LS, Irshad A, Wood J, Kepecs D, Klauber-DeMore N (2018) The value of a second opinion for breast cancer patients referred to a national cancer institute (NCI)-designated cancer center with a multidisciplinary breast tumor board. Ann Surg Oncol 25(10):2953–2957

    Article  PubMed  PubMed Central  Google Scholar 

  32. ACS (2023) COVID-19: recommendations for management of elective surgical procedures. https://www.facs.org/for-medical-professionals/covid-19/clinical-guidance/elective-surgery/. Accessed 4 Oct 2023

  33. COVID19 Subcommittee of the OR Executive Committee at Memorial Sloan Kettering (2020) Cancer surgery and COVID19. Ann Surg Oncol 27(6):1713–1716

    Article  PubMed Central  Google Scholar 

  34. Lum SS, Browner AE, Palis B et al (2023) Disruption of national cancer database data models in the first year of the COVID-19 pandemic. JAMA Surg 158(6):643–650

    Article  PubMed  Google Scholar 

  35. Berrian JL, Liu Y, Lian M, Schmaltz CL, Colditz GA (2021) Relationship between insurance status and outcomes for patients with breast cancer in Missouri. Cancer 127(6):931–937

    Article  PubMed  Google Scholar 

  36. Schermerhorn MC, Grunvald MW, O’Donoghue CM, Rao RD, Becerra AZ (2022) Factors mediating racial/ethnic disparities in delayed treatment of breast cancer. Ann Surg Oncol 29(12):7652–7658

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sheni R, Qin J, Viswanathan S, Castellucci E, Kalnicki S, Mehta V (2023) Predictive factors for cancer treatment delay in a racially diverse and socioeconomically disadvantaged urban population. JCO Oncol Pract 19(6):e904–e915

    Article  PubMed  Google Scholar 

  38. Neilson T, Huynh V, Macdonald A et al (2023) Financial toxicity of breast cancer care: the patient perspective through surveys and interviews. J Surg Res 281:122–129

    Article  PubMed  Google Scholar 

  39. Hendren S, Chin N, Fisher S et al (2011) Patients’ barriers to receipt of cancer care, and factors associated with needing more assistance from a patient navigator. J Natl Med Assoc 103(8):701–710

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge the Breast Cancer Mary Dillon Research Fund and the efforts of Samuel Christiansen who assisted with data coding.

Funding

This work was supported in part by the Breast Cancer Mary Dillon Research Fund.

Author information

Authors and Affiliations

  1. Department of Surgery, NorthShore University Health System, Evanston, IL, USA

    Marie L. Fefferman, Danielle Thompson, Sandra Simovic, Riley J. Medenwald & Katharine Yao

  2. Department of Surgery, The University of Chicago, Chicago, IL, USA

    Marie L. Fefferman, Danielle Thompson & Katharine Yao

  3. Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    Tammy K. Stump

Authors
  1. Marie L. Fefferman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tammy K. Stump
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Danielle Thompson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sandra Simovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Riley J. Medenwald
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Katharine Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MF—Conceptualization, Methodology, Formal analysis, Writing the original manuscript, Editing the manuscript, Visualization of the manuscript. TS—Conceptualization, Data investigation, Methodology, Formal analysis, Editing the manuscript. DT—Conceptualization, Editing the manuscript. SS—Project administration, Data curation, Editing the manuscript. RM—Project administration, Data curation. KY—Supervision, Conceptualization, Methodology, Funding acquisition, Editing the manuscript.

Corresponding author

Correspondence to Katharine Yao.

Ethics declarations

Competing interests

The authors have no relevant financial or non-financial interests to disclose apart from the funding previously noted in “statements and declarations.”

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fefferman, M.L., Stump, T.K., Thompson, D. et al. Patient-reported observations on medical procedure timeliness (PROMPT) in breast cancer: a qualitative study. Breast Cancer Res Treat (2024). https://doi.org/10.1007/s10549-024-07406-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10549-024-07406-7

Keywords

Search

Navigation