Community Outreach: Inside a Community Tumor Board. Prevention, Treatment, and Survivorship in Breast Cancer

November 2017 Vol 8, No 11
Heidi Eve-Cahoon, MSN, RN, CNP, CBCN
Summa Health, Akron, OH
Sharon Inzetta, RN, MS, CBCN, CN-BN
Summa Health System Akron City Hospital Breast Center, Akron, OH
Melanie Lynch, MD, FACS
Summa Health, Akron, OH
Laura Musarra, BS, MBA
Summa Health, Akron, OH

Background: Today there are ever-increasing challenges surrounding breast cancer care. The ongoing disparities in delivering cancer care continue to impact our nation as a whole, and, more importantly, for both patients and providers in our local communities.

The National Accreditation Program for Breast Centers (NAPBC), Standard 4.1 identifies that each year 2 or more breast cancer education, prevention, and/or early detection programs are provided on-site or coordinated with other facilities or local agencies and targeted to the community. Summa Health’s Breast Program Leadership planned and presented a Community Interdisciplinary Breast Conference. The conference provided an educational outreach event offering community members, primary care physicians, nurses, ancillary staff, survivors, and philanthropists an opportunity to experience case presentations involving interdisciplinary breast cancer care. Healthcare providers earned continuing medical education (CME) credit.

Objectives: (1) Explore how family history, genetics, and genomics contribute to individualized treatment planning; (2) Discuss the social, emotional, ethical, financial, palliative, and personal issues surrounding breast cancer survivors, caregivers, and support persons; (3) Explore the role of integrative medicine impacting referrals, individualized supportive care, surveillance, and improved outcomes; (4) Identify barriers to breast cancer treatment planning and referrals involved in coordinating treatment planning and survivorship care; and (5) Discuss national guidelines, evidence-based care, and new therapies for breast cancer survivorship, treatment, outcomes, and surveillance management.

Methods: Ohio breast and cancer mortality rates are reported higher than the national norm. Our local community is identified as being at higher risk for cancers based on race and behavioral, social, and environmental factors.

A communitywide Interdisciplinary Breast Conference was held in September 2016. Our NAPBC Multidisciplinary Summa Panel of presenters discussed 3 breast cancer patients. The audience had the opportunity to ask questions and hear treatment guidelines referenced by the breast care team using ASCO, ASTRO, and NCCN guidelines. Cases involved discussion and review of imaging, diagnosis, pathology, risk factors, comorbidities, functional status, clinical trials, support and rehabilitation, palliative/hospice differences, and barriers to breast cancer care in an interactive forum. The nurse navigators, members of our Breast Program Leadership, regularly attend our weekly interdisciplinary breast conference. The navigators participated in the discussion addressing barriers to care delivery.

Results: The Breast Community Tumor Board was well attended with 155 participants, including 34% who work outside the healthcare industry. CMEs were offered. Based on 7 pre- and post-educational questions completed by 111 participants, learning increased by an average of 3.2%. Survey results showed 85% of attendees reported they “strongly agree” that they would attend another conference.

Conclusions: Providing value-based care that is high quality and multidisciplinary, with oncology experts, will be the continued challenge for tomorrow. Systems will face escalating costs and will be required to shift to “value-based” payment models of care. Balancing costs for cancer centers while maintaining quality multidisciplinary care will be required.

Continued awareness of the disparities here in our local Akron community will be ongoing. This population will require continued outreach and education targeting cancer awareness and prevention. Our second annual Community Tumor Board is planned for October 2017.

Sources

American Cancer Society. Cancer Facts & Figures 2017. Atlanta, GA: American Cancer Society; 2017. www.cancer.org/research/cancer-facts-sta tistics/all-cancer-facts-figures/cancer-facts-figures-2017.html.

American Society of Clinical Oncology. www.asco.org.

American Society for Radiation Oncology. www.astro.org/home.

Department of Health & Human Services. Healthy People 2020. Recommendation for the Framework and Format of Healthy People 2020. www.healthypeople.gov.

Health Policy Institute of Ohio. Improving population health planning in Ohio: recommendations for improving Ohio’s population healthy planning infrastructure. www.healthpolicyohio.org/populationhealth. 2016.

Institute of Medicine. Crossing the Quality Chasm: New Health System for the 21st Century. Washington, DC: National Academies Press; 2001. www.ncbi.nlm.nih.gov/books/NBK222274.

Nardi EA, Wolfson JA, Rosen ST, et al. Value, access, and cost of cancer care delivery at academic cancer centers. J Natl Compr Cancer Netw. 2016;14:837-847.

National Accreditation Program for Breast Centers Standards Manual 2014. National Comprehensive Cancer Network. www.nccn.org.

Surveillance, Epidemiology, and End Results Program. SEER Cancer Statistics Review 1975-2013. https://seer.cancer.gov/csr/1975_2014.

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Last modified: June 11, 2018

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