Annals of Surgical Oncology

, Volume 24, Issue 3, pp 683–691

Variation in the Types of Providers Participating in Breast Cancer Follow-Up Care: A SEER-Medicare Analysis

  • Heather B. Neuman
  • Jessica R. Schumacher
  • David F. Schneider
  • Emily R. Winslow
  • Rebecca A. Busch
  • Jennifer L. Tucholka
  • Maureen A. Smith
  • Caprice C. Greenberg
Breast Oncology

DOI: 10.1245/s10434-016-5611-7

Cite this article as:
Neuman, H.B., Schumacher, J.R., Schneider, D.F. et al. Ann Surg Oncol (2017) 24: 683. doi:10.1245/s10434-016-5611-7

Abstract

Background

The current guidelines do not delineate the types of providers that should participate in early breast cancer follow-up care (within 3 years after completion of treatment). This study aimed to describe the types of providers participating in early follow-up care of older breast cancer survivors and to identify factors associated with receipt of follow-up care from different types of providers.

Methods

Stages 1–3 breast cancer survivors treated from 2000 to 2007 were identified in the Surveillance, Epidemiology and End results Medicare database (n = 44,306). Oncologist (including medical, radiation, and surgical) follow-up and primary care visits were defined using Medicare specialty provider codes and linked American Medical Association (AMA) Masterfile. The types of providers involved in follow-up care were summarized. Stepped regression models identified factors associated with receipt of medical oncology follow-up care and factors associated with receipt of medical oncology care alone versus combination oncology follow-up care.

Results

Oncology follow-up care was provided for 80 % of the patients: 80 % with a medical oncologist, 46 % with a surgeon, and 39 % with a radiation oncologist after radiation treatment. The patients with larger tumor size, positive axillary nodes, estrogen receptor (ER)-positive status, and chemotherapy treatment were more likely to have medical oncology follow-up care than older patients with higher Charlson comorbidity scores who were not receiving axillary care. The only factor associated with increased likelihood of follow-up care with a combination of oncology providers was regular primary care visits (>2 visits/year).

Conclusions

Substantial variation exists in the types of providers that participate in breast cancer follow-up care. Improved guidance for the types of providers involved and delineation of providers’ responsibilities during follow-up care could lead to improved efficiency and quality of care.

Supplementary material

10434_2016_5611_MOESM1_ESM.docx (16 kb)
Appendix (DOCX 16 kb)

Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Heather B. Neuman
    • 1
    • 2
  • Jessica R. Schumacher
    • 1
  • David F. Schneider
    • 1
  • Emily R. Winslow
    • 1
  • Rebecca A. Busch
    • 1
  • Jennifer L. Tucholka
    • 1
  • Maureen A. Smith
    • 2
    • 3
    • 4
  • Caprice C. Greenberg
    • 1
    • 2
  1. 1.Wisconsin Surgical Outcomes Research Program, Department of SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.University of Wisconsin Carbone Cancer CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  3. 3.Department of Population Health SciencesUW Madison School of Medicine and Public HealthMadisonUSA
  4. 4.Department of Family MedicineUW Madison School of Medicine and Public HealthMadisonUSA

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