Abstract | November 13, 2020

Beyond The Barriers: A Case Series On Advanced Stage Breast and Gynecologic Cancer In New Orleans

Presenting Author: Anjali Deendyal, B.A., M.S., M4, Department of Obstetrics and Gynecology, Tulane University, New Orleans, LA

Co-author: Avani Patel, BS, M4, Tulane University School of Medicine, New Orleans, LA

Learning Objectives

  1. Identify concomitant medical disease and social barriers that can impede follow-up for women of low socioeconomic status.
  2. Demonstrate the effect of delayed care on health outcomes for breast and gynecological cancers.
  3. Implement new strategies to ensure better compliance to follow-up care.

Background/Knowledge Gap: Breast and gynecologic cancer screenings are available to a wide population of female patients through insurance providers and various support programs, however these cancers remain prevalent in our population today. In the context of screening availability, barriers leading to late/end-stage breast and gynecologic cancers must be explored. This report aims to highlight unique barriers that contribute to presentation with late-stage breast and gynecologic cancer in women of low socioeconomic status.

Methods/Design: Overall, six patients were reviewed who developed late/end-stage breast and gynecologic cancers. Female OB-GYN patients of low socioeconomic status were chosen with a diagnosis of early stage breast or gynecologic cancer from 2015 to 2019 who were lost to care. A retrospective review of medical records was performed, and barriers were identified that impeded the completion of their treatment course.

Results/Findings: In this review, it was found that this sample of patients faced several comorbidities, such as positive HIV status, substance abuse disorder, heart disease, in addition to socio-economic factors such as incarceration, gun-violence, medication noncompliance and inadequate insurance. In each individual scenario, the patient encountered a unique barrier that prevented recommended follow-up. These barriers were found to have impeded treatment course leading to progression of malignancy.

Conclusions/Implications: As a result of this review, it was found that while these women had an early-stage diagnosis, they faced concomitant medical and/or social barriers to continue regular follow-up with their OB-GYN. These extraneous barriers were not adequately addressed leading to the progression of their disease process. As healthcare providers, it is imperative to develop a system equipped to address multifaceted aspects of patient care to reduce barriers to healthcare access, therefore preventing disease progression.

Posted in: Medical Oncology17 Women’s & Children’s Health27 Breast Cancer2 Gynecologic Cancer1