UNMC Project Aims to Improve Care for Rural Breast Cancer Patients Under 50.

Elizabeth Reed, M.D., UNMC professor of internal medicine and breast cancer expert.


In 2018, an estimated 266,120 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 63,960 new cases of non-invasive breast cancer. About 2,550 new cases of invasive breast cancer are expected to be diagnosed in men in 2018. This is according to breastcancer.org.

Breast cancer typically strikes older women, but it can also affect women in their younger years and be disruptive for a womans plans for a career and family.

With the help of collaborating cancer physicians in Norfolk, North Platte and Grand Island, a team at the Fred & Pamela Buffett Cancer Center at the University of Nebraska Medicine in Omaha, will conduct a quality improvement project to address issues specific to younger patients newly diagnosed with breast cancer.

About 1,300 women in Nebraska are diagnosed every year with breast cancer, but a much smaller number of those are under age 50. Breast cancer patients 50 and under will have an opportunity to participate in the project through their physicians, Ryan Ramaekers, M.D., in Grand Island, Irfan Vaziri, M.D., in North Platte or Rabih Fahed, M.D., in Norfolk.

The two-year project is funded by the National Comprehensive Cancer Network (NCCN) and Pfizer Inc. to improve the quality, effectiveness, and efficiency of cancer care. The NCCN is a not-for-profit alliance of 27 leading cancer centers, which includes the Fred & Pamela Buffett Cancer Center. The NCCN sets standards for cutting-edge treatments and care guidelines.

We want to put the treatment aspects for young breast cancer patients together in one place so its easy for physicians to tap into the latest cancer treatment and support guidelines for their patients, said Elizabeth Reed, M.D., UNMC professor of internal medicine who sees patients at Nebraska Medicine, UNMCs hospital partner. With the help of our collaborating physicians, we will measure the effectiveness of the resources. The goal is to improve the care and satisfaction of patients with the idea that patients participate in shared decision-making as much as possible.

The team will develop a care navigation map specifically for younger women, using NCCN guidelines and continuing education videos produced by experts from UNMC/Nebraska Medicine. The resources will be available online.

The goal is to help the physicians and their patients with decision-making in six primary areas: surgery, fertility counseling, genetic counseling, radiation, hormone therapy practices, and physical-psycho-social consultation and prevention issues.

Another objective is to develop telemedicine connections to enable collaborating physicians to participate in one-hour weekly multidisciplinary consultation clinics regularly held at the medical center. During the clinics, a team of assembled experts at the Fred & Pamela Buffett Cancer Center evaluates patient cases and discusses treatment options.

I am excited to collaborate with UNMC to provide our young breast cancer patients access to the wealth of expertise that this project provides, Dr. Ramaekers said. Our goal is to empower these women with the knowledge they need to make informed decisions about their care.

Those at UNMC involved include Dr. Reed, Robin Lally, Ph.D., UNMC College of Nursing; Brenda Ram, interim director of UNMC Continuing Education; as well as physicians and experts specializing in genetic counseling, radiology, reproductive medicine, reconstructive surgery, urogynecology, physical therapy, psychology/oncology, exercise physiology and survivorship.

University of Nebraska Medical Center