University of Twente Student Theses
The relation of follow-up recommendations after breast cancer during the COVID-19 pandemic to the individual risk of breast cancer recurrence
Hasper, Marvin (2021) The relation of follow-up recommendations after breast cancer during the COVID-19 pandemic to the individual risk of breast cancer recurrence.
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| Abstract: | Introduction: Breast cancer is a common disease. With the increasing incidence and survival, the pressure on follow-up after breast cancer is rising. Follow-up consists of aftercare and post-treatment surveillance. Although the treatment of breast cancer is highly personalized, post-treatment surveillance is still one-size-fits-all. When the COVID-19 pandemic began, an advisory report was introduced by the Dutch Society for Surgical Oncology (NVCO), which implied that post-treatment surveillance in breast cancer patients could be postponed. The degree of postponement in the advisory report depends on several variables. It is not clear whether the risk of recurrence is considered. The research question of this study is: "What is the relation of the advisory report for follow-up after breast cancer during the COVID-19 pandemic from the NVCO to the individual risk of breast cancer recurrence?" Method: A quantitative retrospective study was conducted using a dataset from the Netherlands Cancer Registry (NCR) with female breast cancer patients diagnosed in the Santeon hospitals from 2016 to 2020. With the INFLUENCE-nomogram, a prediction model developed by the University of Twente and the Netherlands Comprehensive Cancer Organisation (IKNL) to determine the locoregional risk of recurrence of breast cancer, the risk of recurrence for the individual patient was estimated. The risks of recurrence of the different groups based on the advisory report were analyzed and compared with the actual risks of the patient groups based on the INFLUENCE-nomogram in which personalized risk is estimated on patient, tumor, and treatment characteristics. The risks between the different groups were tested statistically with a Kruskal-Wallis test. Results: A total of 6691 patients were selected from the NCR. The low-risk group, as mentioned in the NVCO advisory report had on average the lowest 5-year risk of recurrence (3.7%), the intermediate-risk group a higher risk (4.2%) and the high-risk group the highest risk (8.7%, p=0.004). In the low-risk group, there were no patients with a 5-year risk of recurrence above 10%. In the intermediate-risk group, 184 patients had a 5-year risk of recurrence above 10% (5.2%), including 15 patients above 15%. The high-risk group contained 206 patients with a 5-year risk of recurrence of 5% and below (29.8%). Conclusion: The conclusion of this study is that (temporary) policy changes were mostly related to the risk of breast cancer recurrence. If a new pandemic or any other situation where priority needs to be made for the post-treatment surveillance of breast cancer, it is wise, to let the individual risk of recurrence estimated using the INFLUENCE-nomogram form the basis for policy changes and prioritizing patient groups. |
| Item Type: | Essay (Master) |
| Clients: | IKNL, Utrecht, Nederland Santeon, Utrecht, Nederland |
| Faculty: | TNW: Science and Technology |
| Subject: | 01 general works, 33 physics, 44 medicine, 70 social sciences in general |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/89019 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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