Ensuring best practice care for women with early breast cancer after surgery.

The care a woman receives after surgery for breast cancer is important. Surgery is usually the first treatment undertaken after a diagnosis, and this period of care includes recovery from surgery, discussions of prognosis and future management, and the provision of information and support.

In recent years, advances in breast cancer treatment have lead to patients diagnosed with early breast cancer spending less time in hospital after surgery.

Having identified this changing aspect of care, National Breat and Ovarian Cancer Centre (NBOCC)* undertook a comprehensive review of current care provided to women after surgery from 2007 to 2010 to examine whether the reduced time spent in hospital may result in women not having their information and support needs met.

The following research was conducted:

1. systematic international literature review, which identified different models of post-surgical care for women with breast cancer (conducted by NBOCC*, 2008)
2. analysis of national hospital length of stay data from the Australian Institute of Health and Welfare, which identified trends in post-surgical hospital length of stay over the last decade (conducted by NBOCC*, 2007 and 2009)
3. survey of women with breast cancer, which sought to collect information about their experiences of post-surgical care across a range of Australian health service settings (conducted by NBOCC* and Breast Cancer Network Australia, 2008)
4. survey of breast care nurses, which sought to collect information about their experiences in the provision of post-surgical care to women with early breast cancer in Australia (conducted by NBOCC*, 2009)
5. process mapping of post-surgical care models at 8 hospital sites, which included workshops and interviews with clinicians and allied health professionals about the patient journey and the care process (conducted by NBOCC*, 2009).

This body of work culminated in a national forum attended by key clinical experts, health professionals and women who have had breast cancer in July 2010. The forum attendees agreed on priority action areas which will inform recommendations for a new model of evidence-based, best-practice care for women post-surgery.