Younger women with breast cancer are increasingly opting to undergo double mastectomies, even if they were diagnosed with early-stage cancer in only one breast, according to a recent study published in JAMA Surgery.
In some midwestern states (Nebraska, Missouri, Iowa, Colorado, South Dakota), more than 42% of women aged 20-44 who underwent surgery between 2010-12 opted to remove healthy breast along with the affected breast in a procedure known as contralateral prophylactic mastectomy (CPM). When comparing data from 2004-06 with 2010-12, rates of CPM rose across the country, in many cases by double-digit increases and often doubling or tripling from years prior.Last year, the American Society of Breast Surgeons published a consensus statement recommending against the routine use of CPM in women with unilateral breast cancer. The American Board of Internal Medicine has also made a similar statement. There is no clear reason concluded for the increase in CPM, though data from multiple studies cited in the article shows the surgery is clearly on the rise.
“Early and accurate diagnosis is not a trivial problem. We can do better. Why not let machines help us?”
Dig in for this long read—Siddhartha Mukherjee dives into the fascinating world of artificial intelligence in medicine, and its potential to aid with early detection and diagnosis. In one example, a machine-learning algorithm classified 14,000 images into three diagnostic categories (benign, malignant, non-cancerous) and got the answer right 72% of the time. Two board-certified dermatologists who were tested alongside did worse: they got the answer correct 66% of the time.
The Agency for Healthcare Research and Quality is one of the many casualties proposed in President Trump's budget cuts.
Last week, we covered President Trump's proposed $5.8 billion in budget cuts to the NIH. Part of those cuts include merging the NIH with the lesser talked-about Agency for Healthcare Research and Quality. AHRQ uses data to provide evidence-based analysis and applied research for some of the most talked-about medical questions; including the prescribing of opiods, telehealth for rural patients, and treatment of diabetes. Tom Price presented the agency's efforts as duplicative and wasteful; supporters of AHRQ view the decision to merge with the NIH as a misunderstanding of the value data can provide in improving healthcare.
Practices reported physicians and staff spent 15.1 hours per physician per week dealing with external quality measures.
No one said the transition to value would be easy—while this survey from Physicians Foundation is not oncology-specific, it has some eye-opening data points on the costs—both time and money—that the manual tracking of quality measures presents to practices. And speaking of discussions on quality measures...
On the ground: Conversations at Cancerscape
Late last week, community oncology practice professionals gathered in Washington, DC for ACCC's 43rd annual Cancerscape meeting.
Cota's team was in DC last week to connect with Cancerscape attendees. The buzz we heard centered around meeting mandates for value-based care—both OCM and MIPS. The recently announced relaxed reporting for OCM was a welcome relief for practices, though there's still lots of work to figure out the details and prepare for MIPS reporting deadlines. Get a full roundup of this year's conference news highlights on the ACCC site.