Research & Program Areas

Health System Factors and Patient Outcomes in Breast Cancer

Prior studies have shown that women with breast cancer often do not receive the treatments and quality of care they deserve. Gaps in care may reflect inadequate communication between patients and their care team, but those interactions are poorly understood. Moreover, little is known about how delivery system structure and provider relationships vary across oncology practices and the implications of these difference for patients’ experience and outcomes.

In collaboration with the U-M Cancer Surveillance and Outcomes Research Team (CanSORT), CMCD-affiliated researchers gathered information on 1800 women with breast cancer and their surgeons in order to better understand the variations in system delivery structure, process, and patient-centered outcomes including satisfaction with decision-making, utilization of treatments, and health-related quality of life. The goals of this study were to: (1) evaluate clinician and delivery system factors that shape the breast cancer treatment experience and develop a website for surgeons and oncologists treating breast cancer patients in the Detroit area in order to disseminate research findings back to the community-based clinicians who responded to the initial set of surveys.

Investigators found that in general, rates of treatment do not vary considerably based on the treating surgeon (i.e., it doesn’t matter “where you go” for care), with the exception of receipt of reconstruction following mastectomy. In this case receipt was associated with the surgeon’s propensity to refer patients to plastic surgery. The website sub-study indicated community-based surgeons do find it helpful to view research results in a simply formatted and easily accessed way, such as the website. The findings provided the basis for a future website (called “Cancer Doctors Like Me”) that will share a more comprehensive set of patient and clinician data.

For more information, contact Dr. Nancy K. Janz at


Cancer, U-M Health System

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