Perception of breast cancer care differs from actual care quality

In an effort to identify key predictors of women's perceived quality of breast cancer care, Nina A. Bickell, M.D., M.P.H., of the Mount Sinai School of Medicine in New York City, and colleagues conducted a descriptive cohort study of 374 women living in inner city areas with newly diagnosed and surgically treated early-stage breast cancer.

The researchers found that, overall, 55 percent of participants perceived the quality of their breast cancer care to be excellent, even though 88 percent received care of good quality that was consistent with treatment guidelines. The perceived quality of the process of getting care was highly associated with a patient having a perceived quality of care of excellent. A woman's trust in her physician and, for black women especially, her perception of racism significantly affected her perception of care received. The actual quality of care provided did not affect the perception of the quality of care that was received.

"In this study, women's perceived quality of care was not associated with national metrics of good-quality breast cancer care. The processes of getting care, gaining physician trust, and patients' perceived racism independently predicted excellent ratings for quality of care," the authors write. "As physicians and office staff strive to provide excellent patient-centered cancer care, they must improve the way they talk with, treat, and enable patients to help coordinate their own cancer care."

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