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

Devi, Gayathri R

Fish, Laura J

Bennion, Alexandra

Sawin, Gregory E

Weaver, Sarah M

Reddy, Katherine

Saincher, Rashmi

Tran, Anh N

2024-03-06T18:42:24Z

2024-03-06T18:42:24Z

2023-12

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.

S2211-3355(23)00410-2

2211-3355

2211-3355

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

eng

Elsevier BV

Preventive medicine reports

10.1016/j.pmedr.2023.102519

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

Breast cancer

COVID

Health disparity

Medical education

Primary care

Race

Rare disease

Telemedicine

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

Journal article

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

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

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

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

102519

Duke

School of Medicine

Clinical Science Departments

Institutes and Centers

Family Medicine and Community Health

Pathology

Surgery

Family Medicine and Community Health, Community Health

Family Medicine and Community Health, Prevention Research

Surgery, Surgical Sciences

Duke Cancer Institute

Published

36