Identification of barriers at the primary care provider level to improve inflammatory breast cancer diagnosis and management.

dc.contributor.author

Devi, Gayathri R

dc.contributor.author

Fish, Laura J

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Bennion, Alexandra

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Sawin, Gregory E

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Weaver, Sarah M

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Reddy, Katherine

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Saincher, Rashmi

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Tran, Anh N

dc.date.accessioned

2024-03-06T18:42:24Z

dc.date.available

2024-03-06T18:42:24Z

dc.date.issued

2023-12

dc.description.abstract

The purpose of this study, based in the United States, was to evaluate knowledge gaps and barriers related to diagnosis and care of inflammatory breast cancer (IBC), a rare but lethal breast cancer subtype, amongst Primary Care Providers (PCP) as they are often the first point of contact when patients notice initial symptoms. PCP participants in the Duke University Health System, federally qualified health center, corporate employee health and community practices, nearby academic medical center, Duke physician assistant and advanced practice nurse leadership program alumni were first selected in a convenience sample and for semi-structured interviews (n = 11). Based on these data, an online survey tool was developed and disseminated (n = 78) to assess salient measures of IBC diagnosis, health disparity factors, referral and care coordination practices, COVID-19 impact, and continuing medical education (CME). PCP reported access to care and knowledge gaps in symptom recognition (mean = 3.3, range 1-7) as major barriers. Only 31 % reported ever suspecting IBC in a patient. PCP (n = 49) responded being challenged with referral delays in diagnostic imaging. Additionally, since the COVID-19 pandemic started, 63 % reported breast cancer referral delays, and 33 % reported diagnosing less breast cancer. PCP stated interest in CME in their practice for improved diagnosis and patient care, which included online (53 %), lunch time or other in-service training (33 %), patient and provider-facing websites (32 %). Challenges communicating rare cancer information, gaps in confidence in diagnosing IBC, and timely follow-up with patients and specialists underscores the need for developing PCP educational modules to improve guideline-concordant care.

dc.identifier

S2211-3355(23)00410-2

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2211-3355

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2211-3355

dc.identifier.uri

https://hdl.handle.net/10161/30229

dc.language

eng

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Elsevier BV

dc.relation.ispartof

Preventive medicine reports

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10.1016/j.pmedr.2023.102519

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Breast cancer

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COVID

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Health disparity

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Medical education

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Primary care

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Race

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Rare disease

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Telemedicine

dc.title

Identification of barriers at the primary care provider level to improve inflammatory breast cancer diagnosis and management.

dc.type

Journal article

duke.contributor.orcid

Devi, Gayathri R|0000-0001-9158-7289

duke.contributor.orcid

Fish, Laura J|0000-0002-7296-3063

duke.contributor.orcid

Sawin, Gregory E|0000-0001-8541-6416

duke.contributor.orcid

Tran, Anh N|0000-0002-5812-7325

pubs.begin-page

102519

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Duke

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School of Medicine

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Clinical Science Departments

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Institutes and Centers

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Family Medicine and Community Health

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Pathology

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Surgery

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Family Medicine and Community Health, Community Health

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Family Medicine and Community Health, Prevention Research

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Surgery, Surgical Sciences

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Duke Cancer Institute

pubs.publication-status

Published

pubs.volume

36

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