The effect of centralizing breast cancer care in an urban public hospital

Background Quality of care and patient outcomes improve when cancer care is comprehensively centralized. Most patients of lower socioeconomic status in New York City do not receive their cancer care in centralized cancer centers because of the way the medical insurance is structured. In 2002, the Queens Cancer Center was established at Queens Hospital Center in the borough of Queens, to provide consolidated medical, surgical, radiation, gynecologic, and urologic oncology services. Objective To establish whether breast cancer care changed after the establishment of the cancer center by comparing the changes or improvements in treatment modalities and outcomes before and after the center was established. Methods We conducted a retrospective chart review of all patients with stage I, II, or III breast cancer treated in 2000, before the comprehensive center was established, and 2008, after its establishment. Results Several factors changed, including an increase in the number of patients diagnosed with earlier-stage breast cancer, an increase in the use of lumpectomies, and an increase in survival for patients with stage 3 disease. Limitations Retrospective study Conclusions Care for breast cancer patients can be improved by centralizing their care.