A targeted performance improvement program increased the rate at
which physicians and other health care providers recommended the use of
antiestrogen preventive therapy for women with atypical hyperplasia (AH) and lobular cancer in situ (LCIS), according to the results of a single-center study.1
Preventive therapy using the selective estrogen-receptor modulators
(SERMs), tamoxifen and raloxifene, or an aromatase inhibitor is
recommended for all women at high risk of developing breast cancer;
these treatments are strongly recommended in women with AH and LCIS.
Women with AH/LCIS can reduce their risk for breast cancer by as much as
75% with these medications, but fewer than 30% of them take advantage,
primarily because of lack of provider recommendation or concern about
side effects.
“One of the reasons why there is very low uptake reported in the
literature is that these drugs that are used for prevention are also
used to treat women with breast cancer,” explained study researcher
Abenaa M. Brewster, MD, professor of clinical cancer prevention at the
University of Texas MD Anderson Cancer Center in Houston. “In addition,
generally primary care doctors are the ones primarily seeing women at
increased risk and are not very familiar with these drugs. Because of
this lack of familiarity there is reluctance to recommend treatment.”
For this study, Dr Brewster and colleagues implemented a performance
improvement program designed to increase uptake of these preventive
therapies in practices throughout the MD Anderson Cancer Prevention
Center and in satellite clinics. From November 2015 to February 2017,
patients with AH or LCIS were screened prior to their clinic appointment
to determine eligibility. Providers were then alerted to their patients
registered on the program.
“We performed some education, detailing how strongly these
medications work in these patients to reduce the risk of developing
breast cancer, and taught them methods for giving strong
recommendations,” Dr Brewster told Cancer Therapy Advisor.
After the visit, providers and patients were asked to complete a
survey rating the strength of the recommendation for preventive therapy
on a scale from 1 to 5.
Source: https://www.cancertherapyadvisor.com
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