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Study Suggests Minority Women Less Involved in Selecting Surgeon, Hospital

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If you’re diagnosed with breast cancer, you go through a rollercoaster of emotions -- ranging to fear, anger, sadness, and anxiety. Being diagnosed can take weeks and involve many different kinds of tests. On top of that, you have to decide which doctors you want to treat you and work with them to develop a treatment plan that’s best for your unique situation.

Not much research has been done on how women select their breast cancer surgeons. A study suggests that minority women diagnosed with breast cancer are less likely to be actively involved in picking their surgeons and hospitals than white women.

The study was published in the May 2015 issue of JAMA Oncology. Read “Racial/Ethnic Differences in Patients’ Selection of Surgeons and Hospitals for Breast Cancer Surgery.”

In the study, the researchers surveyed northern California women who had been diagnosed with stage 0 to stage III breast cancer between 2010 and 2011:

  • 222 were non-Hispanic white women
  • 142 were non-Hispanic Black women
  • 89 were English-speaking Hispanic women
  • 47 were Spanish-speaking Hispanic women

The researchers asked the women a number of questions about:

  • how they selected their breast cancer surgeons and the hospitals where they were treated for breast cancer
  • their priorities when they made decisions about hospitals; for example, which was more important when choosing the hospital: the location, the reputation, or were both equally important?
  • how they rated the overall quality of care they got from their surgeon and hospital

The researchers also collected information on several other factors, including the women’s insurance coverage, education, and other existing health problems.

Overall, 78% of the women said they chose their surgeon because another doctor had recommended the surgeon, and 58% of the women said they chose their hospital because it was in their health plan.

When the researchers looked at the women’s choices by ethnicity, they found some differences:

  • 87% of Black women and 79% of Spanish-speaking Hispanic women chose their surgeon because another doctor recommended the surgeon compared to 76% of white women
  • 32% of white women chose their surgeon based on the surgeon’s reputation compared to 18% of Black women and 22% of Hispanic women
  • 23% of white women chose their hospital based on reputation compared to 7% of Black women and 15% of Hispanic women

Looking at how the women rated their care, the researchers found that overall, 77% of the women said their surgeon delivered excellent care and 63% said their hospital offered excellent care.

The researchers also found that women who chose their surgeons based on the surgeon’s reputation were more likely to say they had received excellent care. Women who chose a surgeon because the surgeon was part of the woman’s health plan were less likely to report they had received excellent care.

All women, no matter their age, ethnicity, or insurance status, deserve the best care possible if they’ve been diagnosed with breast cancer. If you’ve been diagnosed and would like to consider more options for breast cancer surgeons than the first one recommended to you, you may find the following tips helpful:

  • Use your network of family and friends. You probably know people who have been affected by breast cancer -- either through their own diagnosis or the experience of a family member. Ask around and find out which doctor(s) they saw and whether they were happy with the care they received.
  • Search the websites of major cancer centers or medical centers in your area or call the physician referral line. You should be able to find the names of surgeons who specialize in breast cancer, as well as information about their backgrounds and training. If traveling outside your area is an option, then you can do a broader Internet search for breast cancer specialists.
  • Target your search within the National Cancer Institute (NCI)-designated cancer centers. The NCI, part of the federal government’s National Institutes of Health, has recognized 68 cancer centers nationwide for “scientific excellence and the capability to integrate a diversity of research approaches to focus on the problem of cancer.” Most of these centers treat people with cancer, although some focus only on research. Breast cancer experts at these centers are likely to be up-to-date on the latest diagnostic techniques and treatment options. In addition to searching online, you can call the NCI’s Cancer Information Service at 1-800-4-CANCER or talk to a specialist through the NCI’s chat service, LiveHelp.
  • Post a request to an online forum or support group, such as the Discussion Boards here at People in your area or region may have recommendations based on their own experiences and research.

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