Time to treatment and hospital visits for patients undergoing neoadjuvant chemotherapy for breast cancer in a single payer system

Abstract

Background and Objectives Neoadjuvant chemotherapy (NAC) requires coordination of various services to ensure timely and accurate delivery of care. This can result in multiple hospital visits and extend time to treatment (TTT). The primary purpose of our study was to evaluate time to NAC for patients at a regional cancer centre. Healthcare resource use in the form of hospital visits before NAC was also evaluated. Methods A retrospective chart analysis of patients with invasive breast cancer who underwent NAC between 1 January 2012 and 31 December 2018 was performed. Results Overall, 286 patients underwent NAC. Median TTT was 22 days (range: 2–105). Median number of visits between first consultation and NAC was 5 (range: 0–12). Majority of additional visits were for diagnostic imaging/interventions, with a median number of 4 visits (range: 0–10). Each additional hospital visit increased time to NAC treatment by 14%. Conclusions Women undergoing NAC require multiple visits before initiating treatment—the majority of these visits are for diagnostic imaging. These results support the need for the coordination of multidisciplinary care and diagnostic imaging for breast cancer patients undergoing NAC to reduce hospital visits, improve the patient experience, and reduce TTT.