Which Chemotherapy Treatment Setting Best Predicts the 5-year Survival Rates in Women Diagnosed with Triple Negative Breast Cancer?
Date of Award
Spring 2024
Document Type
Dissertation
Degree Name
Doctor of Healthcare Administration (DHA)
Committee Chair
Jeffrey Ferezan
Committee Member
John Suozzi
Committee Member
Cynthia Smoak
Abstract
Female breast cancer contributes to over two million cancer cases each year worldwide and remains a top contributor to mortality. Expedient treatment may mean the difference between positive and negative survivor outcomes but when facing an aggressive subtype with no targeted treatment, how do oncologists get quick and correct care to their patients? Triple negative breast cancer accounts for approximately 15% of all breast cancer diagnoses each year. These patients are faced with a highly aggressive cancer that lacks positivity for all three molecular markers that can guide treatment. These patients are often younger, have multiple comorbidities, and have socioeconomic disparities that may affect their access to care. Understanding that triple negative breast cancer is chemosensitive, polychemotherapy remains the backbone of TNBC treatment. This research will delve into predictors that can affect time to treatment and survivor outcomes based on chemotherapy setting administration (adjuvant or neoadjuvant). This quantitative study utilizes the National Cancer Database – Public Use Files to identify triple negative breast cancer patients residing within the mid-Atlantic (New York, New Jersey, Pennsylvania) between 2004 and 2014 who had both chemotherapy and surgery as their treatment protocol (n = 4,528). Using generalized linear models and Cox Proportional Hazard Regressions, the data found that women treated in a comprehensive community cancer program had an average time to treatment of 3.7 days from date of diagnosis. Patients who were privately insured encountered a margin decrease in treatment time, waiting 3.5 days. Additionally, the analysis indicated that there is no significant difference in survivor outcomes at 60 months between adjuvant or neo-adjuvant chemotherapy administration. Hospital administration and healthcare leaders must be capable of providing insight and support to clinicians and encourage multidisciplinary collaboration. This collaboration can lead to organizational change by developing solutions that benefit patient outcomes, maintain financial stewardship, and improve quality and regulatory compliance.
Recommended Citation
Eck, Allison, "Which Chemotherapy Treatment Setting Best Predicts the 5-year Survival Rates in Women Diagnosed with Triple Negative Breast Cancer?" (2024). All Doctoral Student Dissertations. 152.
https://fuse.franklin.edu/docpub/152