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More Pre-Op Tests…More Anxiety…More Expense

Posted on the 30 December 2011 by Jean Campbell

testsDr. Richard Bleicher, an associate professor of surgical oncology at Fox Chase Cancer Center in Philadelphia presented at the San Antonio Breast Cancer Symposium on the findings of a study he conducted on the increased incidence of pre-surgical tests for women diagnosed with breast cancer from 1992-2005.

During this time, Dr. Bleicher, a breast surgeon, evaluated data on more than 67,000 women in the United States looking to document the time and inconvenience involved in multiple imaging appointments. Study researchers used Medicare claims linked to the U.S. National Cancer Institute’s Surveillance Epidemiology End Results data for women with breast cancer.

His findings confirm what those of us who have  gone through breast cancer already know. While ultrasounds, MRIs and diagnostic tests help doctors decide the best course of treatment, for the patient they equal more anxiety and more expense. The anxiety curve increases when tests, because of provider scheduling issues, are spread out over a period of weeks.

Dr. Bleicher reported that women with breast cancer have many more imaging tests between diagnosis and surgery than they did in the early 1990s.

He found that in 1992 1 in 20, or less than 5 %  of patients, had imaging twice or more during the preoperative period of about 37 days. By 2005, 1 in 5 patients, or nearly 20 %, had two or more imaging sessions. The percentage of patients who had more than one type of imaging on a given day increased more than six-fold, from about 4 percent in 1992 to just over 27 percent in 2005.

“Patients are having a lot more imaging done overall,” Dr. Bleicher reported. “I can’t tell you whether the imaging was appropriate or not appropriate.”

Dr. Bleicher urged his colleagues to consider ways of streamlining the tests, with an eye to improving treatment without raising costs. He spoke of the hardship that increased tests has for older women who need assistance in coordinating their testing in preparation for surgery.

Dr.Bleicher suggests that if your doctor recommends additional imaging tests, to ask why they are needed. If you do need additional tests ask whether it’s possible to schedule tests on the same day.

(SOURCE: Richard J. Bleicher, M.D., breast surgeon and associate professor of surgical oncology, Fox Chase Cancer Center, Philadelphia, San Antonio Breast Cancer Symposium, December, 2011 )

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