Katharine A. Yao, M.D.

Katharine A. Yao, M.D.

Katharine A. Yao, M.D.

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Conditions & Procedures

Conditions

Breast Cancer, Melanoma

Procedures

Axillary Node Dissection, Groin Dissection for Melanoma, Nipple Sparing Mastectomy, Sentinel Node Biopsy, Surgical Oncology in Breast

General Information

Gender

Female

Affiliation

NorthShore Medical Group

Expertise

Breast Surgery

Academic Rank

Clinical Professor

Languages

English

Board Certified

Surgery

Clinical Service

Surgical Oncology

Education, Training & Fellowships

Medical School

South Illinois University School of Medicine, 1994

Residency

McGaw Medical Center of Northwestern University, 2001

Fellowship

John Wayne Cancer Institute, 2003

Locations

A

NorthShore Medical Group

2650 Ridge Ave.
Suite 1155
Evanston, IL 60201
847.570.1700 847.733.5298 fax Get Directions This location is wheelchair accessible.
B

NorthShore Medical Group

2650 Ridge Ave.
Kellogg Cancer Center
Evanston, IL 60201
847.570.1700 847.733.5298 fax Get Directions This location is wheelchair accessible.

Insurance

For behavioral health services, please confirm participation with your insurance company or provider.

2017 Exchange Plans (Individuals)

 
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Ambetter Insured By Celtic
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Basic PPO A Multi-State Plan
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Blue Cross Blue Shield Blue Choice Preferred PPO (All Plans)
PRIMARY CARE
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HOSPITALS
 
 
 
Blue Cross Blue Shield Blue FocusCare HMO
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SPECIALTY CARE
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Blue Cross Blue Shield Blue Precision HMO (All Plans)
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Blue Cross Blue Shield Blue Premier PPO A Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Solution PPO A Multi-State Plan
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HOSPITALS
 
 
 
Blue Cross Blue Shield BlueCare Direct with Advocate HMO
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SPECIALTY CARE
HOSPITALS
 
 
 
Cigna Connect HMO
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Cigna Connect HSA
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Off Exchange Plans (Individuals)

 
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Aetna Bronze Deductible Only HSA Eligible Savings Plus OAMC PD
Not Available In 2017
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Aetna Leap Everday Value Plan
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Aetna Leap Everyday Carelink Centegra Health System
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Aetna Savings Plus OAMC PD (All Metal Tiers)
Not Available In 2017
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Aetna Whole Health Chicago (All Metal Tiers)
Not available for 2017
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SPECIALTY CARE
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Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
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Ambetter Insured By Celtic
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Blue Cross Blue Shield Blue Choice Preferred PPO (All Plans)
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Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
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Blue Cross Blue Shield Blue Cross Blue Premier 101 Multi-State Plan
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Blue Cross Blue Shield Blue Cross Blue Shield Basic 103 Multi-State Plan
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Blue Cross Blue Shield Blue Precision HMO (all plans)
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Blue Cross Blue Shield Blue Precision Platinum HMO 104
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Blue Cross Blue Shield BlueCare Direct with Advocate
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Blue Cross Blue Shield Solution 102 Multi-State Plan
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Coventry $15 Copay: Silver & Gold
Not Available In 2017
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Coventry Bronze $10 Copay Carelink St. John's
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Coventry Bronze $15 Copay Carelink St. John's
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Coventry Bronze $20 Copay
Not Available In 2017
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SPECIALTY CARE
HOSPITALS
Coventry Bronze Deductible Only HSA Eligible
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Harken Health - an Affiliate of United Healthcare
PRIMARY CARE
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Health Alliance HMO (All Metal Tiers)
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Health Alliance POS (All Metal Tiers)
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Health Alliance PPO (All Metal Tiers)
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Humana Chicago HMOx (All Metal Tiers)
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Humana Illinois HMOx
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United Health One Golden Rule
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United Healthcare Compass (All Plans)
Not Available In 2017
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Employer Sponsored Plans

 
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Aetna Choice POS II
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Aetna HMO
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Aetna Managed Choice
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Aetna Network Options
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Aetna Open Access Aetna Select
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Aetna Open Access Managed Choice
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Aetna Open Choice PPO
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Aetna Savings Plus
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Aetna Select
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Aetna Sub- Cofinity
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Aetna Sub- First Health
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Aetna Traditional Choice-Indemnity Plan
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Aetna Whole Health Chicago (All Metal Tiers)
For employers with 2-50 employees
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Beechstreet PPO Network
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Blue Cross Blue Shield Blue Advantage HMO
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Blue Cross Blue Shield Blue Choice Options PPO (All Metal Tiers)
Participating in Tier 2, there may be higher out of pocket costs
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Blue Cross Blue Shield Blue Choice Preferred PPO (All Plans)
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Blue Cross Blue Shield Blue Choice Select PPO
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Blue Cross Blue Shield Blue Choice Select Value Choice
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Blue Cross Blue Shield Blue Distinction Total Care Benefit Differentail
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Blue Cross Blue Shield Blue PPO (All Metal Tiers)
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Blue Cross Blue Shield Blue Precision HMO Plans (All Metal Tiers)
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Blue Cross Blue Shield BlueCare Direct (All Metal Tiers)
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Blue Cross Blue Shield BlueEdge HSA and BlueEdge HCA
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Blue Cross Blue Shield BluePrint
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Blue Cross Blue Shield Community Participating Option
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Blue Cross Blue Shield HMOI
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Blue Cross Blue Shield PPO
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Blue Cross Blue Shield PPO Value Choice
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Cigna Exclusive Provider Organization EPO
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Cigna Great West Healthcare (GWH) Cigna Network
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Cigna HMO
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Cigna HMO Open Access
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Cigna HMO Open Access POS
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Cigna HMO POS
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Cigna Medical PPO
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Cigna Medical LocalPlus
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Cigna Medical LocalPlus In-Network
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Cigna Medical Network
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Cigna Medical Network POS
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Cigna Medical Open Access Plus (OAP)
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Cigna Medical Open Access Plus (OAP) In-Network
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Cigna Medical Open Access POS
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Cofinity PPO (an Aetna Company)
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Coventry Consumer Choices (C3)
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Coventry HMO
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Coventry POS
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Coventry PPO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Galaxy Health Network
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Harken Health
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Health Alliance HMO, PPO, POS, POS-C
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Health Link HMO
If Unicare Affiliate logo present on card
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Health Link PPO
If Unicare Affiliate logo present on card
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Health Link-Open Access I, II, III
If Unicare Affiliate logo present on card
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Healthcare's Finest Network- FHN 10 & 20
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Healthcare's Finest Network- FHN Platinum
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Healthcare's Finest Network- HFN Community Health Connect
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SPECIALTY CARE
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Healthcare's Finest Network- HFN Community Health Connect Elite
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Healthcare's Finest Network- HFN Community Health Connect Premiere
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Healthcare's Finest Network- HFN-ID
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Humana Advocate Centered EPO
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Humana Advocate Centered HMO
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Humana Choice POS
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Humana Classic Plan (Traditional Indemnity Plan)
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Humana Coinsurance: NPOS
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Humana Coinsurance: PPO
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Humana Coinsurance:HMO
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Humana Condell Custom PPO
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Humana Copay: HMO
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Humana Copay: NPOS
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Humana Copay: PPO
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Humana COT National POS-Open Access
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Humana Edward- Elmhurst Value HMO
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Humana Edward-Elmhurst Advantage HSA/Choice PPO
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Humana High-deductible plans (HDHP) HMO
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Humana High-deductible plans (HDHP) National point of service (NPOS)
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Humana High-deductible plans (HDHP) PPO
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Humana Illinois Coordinated Care
Available In 2017
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Humana Level Funded Premium
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Humana NorthShore Complete Care
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Humana Self Funding: Administrative Services Only (ASO)
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Humana Self-Funding: Level Funded Premium (LFP)
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Humana Self-Funding: Minimum Premium (MP)
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Humana Self-Funding: Stop Loss Insurance
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Humana Simplicity (HMO, POS, PPO)
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Humana Total Health (100 or more employees)
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Multiplan/ PHCS- Health EOS Network
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Multiplan/ PHCS- MultiPlan Complementary
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Multiplan/ PHCS- MultiPlan Limited Benefit Plan
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Multiplan/ PHCS- MultiPlan Practitioner Only
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Multiplan/ PHCS- MultiPlan Shared Savings
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Multiplan/ PHCS- PHCS Healthy Directions
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Multiplan/ PHCS- PHCS Practitioner Only
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Multiplan/ PHCS- PHCS Savility
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SPECIALTY CARE
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Multiplan/ PHCS- ValuePoint by MultiPlan
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SPECIALTY CARE
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NorthShore Employee Network
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Preferred Network Access
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Preferred Plan- HealthSmart Get Better
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Preferred Plan PPO
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Stratose- National Preferred Provider Network
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Three Rivers Provider PPO Network (TRPN)
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UniCare HMO
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UniCare HMO Performance Select
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Unicare PPO
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UniCare Travel Access
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United Health One Golden Rule
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United Healthcare Catalyst
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United Healthcare Charter
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United Healthcare Choice
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United Healthcare Choice Plus
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United Healthcare Core
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United Healthcare Heritage
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United Healthcare Multi-Choice
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United Healthcare Navigate and Navigate Plus
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United Healthcare Options Non-Differential PPO
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United Healthcare Options PPO
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United Healthcare Tiered Benefits
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Medicaid

 
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Aetna Better Health FHP
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Aetna Better Health ICP
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Blue Cross Blue Shield Community FHP
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Blue Cross Blue Shield Community ICP
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Cigna HealthSpring ICP
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Community Care Alliance- ICP
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Family Health Network- FHP
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Harmony/WellCare FHP Plan
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Humana ICP
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Illinicare Family Health Plan (FHP/ACA)
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Illinicare ICP
Primary Care- Current Patients Only
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Illinois Department of Public Aid (IDPA)
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Meridian FHP/ACA Expansion
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Meridian ICP
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Molina ICP
PRIMARY CARE
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Next Level ACA/FHP
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Medicare Advantage Plans

 
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Aetna Medicare (SM) Plan (HMO)
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Aetna Medicare (SM) Plan (PPO)
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Aetna Medicare Advantage Group Plans
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Aetna Medicare Connect Plus (PPO)/PPO Connect Plus
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Aetna Medicare Standard Plan (PPO)/PPO Standard Plan
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Aetna Medicare Value Plan (HMO)/HMO Value
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Aetna Medicare Value Plan (PPO)/PPO Value Plan
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Aetna Traditional Choice Plan
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Blue Cross Blue Shield Medicare Advantage Basic HMO
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Blue Cross Blue Shield Medicare Advantage Basic Plus HMO-POS
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Blue Cross Blue Shield Medicare Advantage Choice Plus PPO
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Blue Cross Blue Shield Medicare Advantage Choice Premier PPO
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Blue Cross Blue Shield Medicare Advantage Premier Plus HMO-POS
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Cigna-HealthSpring Advantage HMO
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Cigna-HealthSpring Premier HMO-POS
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Cigna-HealthSpring Primary HMO
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Cigna-HealthSpring TotalCare HMO-SNP
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Community Care Alliance Complete HMO-D-SNP
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Community Care Alliance HMO
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Harmony/WellCare Access (HMO-SNP)
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Harmony/WellCare Choice (HMO-POS)
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Harmony/WellCare Health Plan
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Harmony/WellCare RX (HMO)
PRIMARY CARE
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Harmony/WellCare Value (HMO-POS)
PRIMARY CARE
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Harmony/WellCare-Medicare HMO Plans
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Harmony/WellCare-Medicare Special Needs Plans
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Humana Choice PPO
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Humana Community HMO Diabetes and Heart (SNP Program)
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Humana Gold Plus HMO
PRIMARY CARE
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Humana Gold Plus PFFS
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Meridian Medicare Advantage
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Molina Medicare Advantage
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United Healthcare - AARP Medicare Complete
PRIMARY CARE
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United Healthcare AARP Medicare Complete Access
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United Healthcare- AARP Medicare Complete Plus (HMO-POS)
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United Healthcare Medicare Advantage Focus
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United Healthcare- Medicare Solutions/Medicare Advantage
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Medicare Medicaid Alignment Initiative (MMAI) Plans

 
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Aetna Better Health MMAI
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Blue Cross Blue Shield Community MLTSS/LTSS
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Blue Cross Blue Shield Community MMAI
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Cigna-HealthSpring MMAI
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Humana MMAI
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Illinicare MLTSS/LTSS
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Illinicare MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Molina MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 

Medicare Supplemental Plans

 
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Medicare Supplemental Plans
These plans are secondary to Traditional Medicare; we accept all supplemental plans. Please confirm your coverage benefits with your supplemental carrier.
PRIMARY CARE
SPECIALTY CARE
HOSPITALS

Coverage For Active Military

 
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
TRICARE For Life
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
TRICARE Prime
PRIMARY CARE
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TRICARE Prime Overseas
PRIMARY CARE
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TRICARE Prime Remote
PRIMARY CARE
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TRICARE Prime Remote Overseas
PRIMARY CARE
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TRICARE Reserve Select
PRIMARY CARE
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HOSPITALS
 
 
TRICARE Retired Reserve
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
TRICARE Standard and Extra
PRIMARY CARE
SPECIALTY CARE
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TRICARE Standard Overseas
PRIMARY CARE
SPECIALTY CARE
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TRICARE US Family Plan
PRIMARY CARE
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TRICARE Young Adult
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Publications

  • Evaluation of the Quality of Adjuvant Endocrine Therapy Delivery for Breast Cancer Care in the United States.

    JAMA oncology 2017 Feb 02

    Authors: Daly B, Olopade OI, Hou N, Yao K, Winchester DJ, Huo D
    Abstract
    Randomized trials in breast cancer have demonstrated the clinical benefits of adjuvant endocrine therapy (AET) in preventing recurrence and death. The examination of concordance with AET guidelines at a national level as a measure of quality of care is important.
    To investigate temporal trends and factors related to receipt of AET for breast cancer.
    This retrospective cohort study included 981 729 women with breast cancer in the National Cancer Database from January 1, 2004, to December 31, 2013. Women with stages I to III breast cancer who received all or part of their treatment at the reporting institution were included in the analysis.
    Temporal changes in AET receipt (estimating the annual percentage change) and AET practice patterns (using logistic regression) and the effect of AET guideline concordance on survival of women with hormone receptor-positive (HR+) breast cancer (using the multivariable Cox proportional hazards model).
    Of the 981 729 eligible patients (mean [SD] age, 60.8 [13.3] years), 818 435 had HR+ and 163 294 had HR-negative (HR-) cancer. Among the patients with HR+ cancer, receipt of AET increased over time, from 69.8% in 2004 to 82.4% in 2013. Among patients with HR- cancer, receipt decreased from 5.2% in 2004 to 3.4% in 2013. Hospital-level adherence (≥80% of patients with HR+ cancer received AET) increased from 40.2% in 2004 to 69.2% in 2013. Receipt of AET varied significantly by age (lower in patients ≥80 years), race (lower in African American and Hispanic participants), geographic location (lower in West South Central, Moutain, and Pacific census regions), and receptor status (lower in patients with estrogen receptor-negative and progesterone receptor-positive cancer). Surgery and radiotherapy were the factors most significantly associated with appropriate AET receipt (only 45.0% in patients who received lumpectomy without radiotherapy). Receipt of AET was associated with a 29% relative risk reduction in mortality. Based on this effectiveness estimate, if all patients with HR+ cancer received AET, approximately 14 630 lives would have been saved over 10 years.
    From 2004 to 2013, underuse and misuse of AET have decreased for patients with breast cancer, but optimal use has not been achieved, and significant variation in care remains. The involvement of surgery and radiotherapy were among the most significant factors associated with optimal use, which underscores the benefits of team-based care to support guideline-concordant therapy.
    PMID: 28152150 [PubMed - as supplied by publisher]
  • Utilization trend and regimens of hypofractionated whole breast radiation therapy in the United States.

    Breast cancer research and treatment 2017 Jan 24

    Authors: Hasan Y, Waller J, Yao K, Chmura SJ, Huo D
    Abstract
    We aimed to evaluate the adoption of hypofractionated whole-breast irradiation (HF-WBI) over time and factors related to its adoption for patients undergoing lumpectomy. We also examined whether HF-WBI can increase the overall use of radiotherapy.
    Using data from the National Cancer Database between 2004 and 2013, we identified 528,051 invasive and 190,431 ductal carcinoma in situ (DCIS) patients who underwent lumpectomy. HF-WBI was defined as 2.5-3.33 Gy/fraction to the breast, whereas conventional therapy (CF-WBI) was defined as 1.8-2.0 Gy/fraction.
    The usage of HF-WBI among invasive cancer patients increased from 0.7% in 2004 to 15.6% in 2013, and among DCIS patients, HF-WBI increased from 0.4% in 2004 to 13.4% in 2013. However, these changes only lead to a slight increase in the overall use of radiotherapy. Interestingly, for DCIS patients who lived ≥50 miles from hospitals, the uptake of HF-WBI translated to a moderate increase in the overall use of radiotherapy (58% in 2004 to 63% in 2013). Multivariable logistic regression showed that older age, node-negative or smaller tumor, living in mountain states, rural area, or ≥50 miles from hospitals, and treated in large or academic cancer centers were associated with elevated HF-WBI use. The median duration of finishing radiotherapy for HF-WBI was 26 days, compared to 47 days for CF-WBI.
    Although HF-WBI can save 3 weeks of patient time, its adoption remained low in the US. There was only a slight increase in the overall use of radiotherapy among patients undergoing lumpectomy.
    PMID: 28120272 [PubMed - as supplied by publisher]
  • Post-mastectomy radiation therapy and overall survival after neoadjuvant chemotherapy.

    Journal of surgical oncology 2017 Jan 13

    Authors: Kantor O, Pesce C, Singh P, Miller M, Tseng J, Wang CH, Winchester DJ, Yao K
    Abstract
    The role of postmastectomy radiation therapy (PMRT) after neoadjuvant chemotherapy (NAC) and mastectomy is unclear, especially in patients that have post-treatment tumor negative axillary nodes (ypN0).
    The National Cancer Data Base was used to identify women that had PMRT after NAC and mastectomy for clinically node positive (cN1-2) disease from 2004 to 2008. Median follow-up time was 69 months.
    8,321 patients were included for analysis, and 6140 (65.6%) had cN1 disease and 2181 (23.3%) had cN2 disease. On adjusted survival analysis, PMRT was associated with an overall survival (OS) benefit in both patients with cN1 (5-yr OS 75.8% vs. 71.9%, P < 0.01) and cN2 (5-yr OS 69.2% vs. 58.6%, P < 0.01) disease. In the subgroup of patients that were ypN0 after NAC, there was no significant survival difference (P > 0.11) for PMRT compared to those patients who were not ypN0, except for patients with hormone-receptor negative tumors, who had improved OS with PMRT (HR 0.65, P < 0.01).
    PMRT is associated with improved OS in patients with cN1 and cN2 disease after NAC and mastectomy. However, in the subgroup of patients that were ypN0 after NAC, PMRT improved OS for hormone-receptor negative patients but not hormone-receptor positive patients.
    PMID: 28083910 [PubMed - as supplied by publisher]
  • National Accreditation Program for Breast Centers Accreditation Demonstrates Improved Compliance with Post-Mastectomy Radiation Therapy Quality Measure.

    Journal of the American College of Surgeons 2016 Dec 16

    Authors: Berger ER, Wang CE, Kaufman CS, Williamson TJ, Ibarra JA, Pollitt K, Bleicher RJ, Connolly JL, Winchester DP, Yao KA
    Abstract
    The National Accreditation Program for Breast Centers (NAPBC) was established in 2008 by the American College of Surgeons as a quality improvement program for patients with breast disease. An NAPBC quality measure states post-mastectomy patients with ≥4 positive lymph nodes should receive lymph node radiation therapy (PMRT). Our objective was to examine how NAPBC accreditation has affected compliance with this quality measure.
    Women who underwent mastectomy at either an NAPBC-accredited center or a CoC only accredited hospital were identified (2006-2013) in the National Cancer Data Base(NCDB). NAPBC centers accredited from 2009-2011 were included in the analysis. Patients were nested within centers using a mixed effects model to identify PMRT rates at each center prior to and after accreditation, adjusting for patient and tumor characteristics.
    Of 34,752 patients from 477 NAPBC-accredited centers and 958 CoC-only accredited hospitals who underwent mastectomy with ≥4 positive lymph nodes, 21,638 patients received PMRT during the study period (62.3%). NAPBC centers yielded a significantly higher rate of PMRT than CoC hospitals (66.0% vs 59.2%, p<0.001). For each year of accreditation (2009-2011), centers had significantly higher rates of radiation in the accreditation year compared to the year prior to accreditation (p <0.001). Within those centers, the rate of radiation increased post-accreditation in each accreditation year (2009: 62.1% to 71.9%; 2010: 65.5% to 73.2%; 2011: 67.5% to 70.4%).
    NAPBC-accreditation is associated with higher PMRT rates and thus better adherence to the PMRT quality measure. Future studies with more centers and longer follow-up are needed to determine if this trend continues.
    PMID: 27993697 [PubMed - as supplied by publisher]
  • Impact of an In-visit Decision Aid on Patient Knowledge about Contralateral Prophylactic Mastectomy: A Pilot Study.

    Annals of surgical oncology 2017 Jan

    Authors: Yao K, Belkora J, Bedrosian I, Rosenberg S, Sisco M, Barrera E, Kyrillios A, Tilburt J, Wang C, Rabbitt S, Pesce C, Simovic S, Winchester DJ, Sepucha K
    Abstract
    Studies have reported that breast cancer patients have limited understanding about the oncologic outcomes following contralateral prophylactic mastectomy (CPM). We hypothesized that an in-visit decision aid (DA) would be associated with higher patient knowledge about the anticipated short and long term outcomes of CPM.
    We piloted a DA which used the SCOPED: (Situation, Choices, Objectives, People, Evaluation and Decision) framework. Knowledge, dichotomized as "low" (≤3 correct) versus "high" (≥4 correct), was assessed immediately after the visit by a 5 item survey. There were 97 DA patients (response rate 62.2 %) and 114 usual care (UC) patients (response rate 71.3 %).
    Patient demographic factors were similar between the two groups. Twenty-one (21.7 %) patients in the DA group underwent CPM compared with 18 (15.8 %) in the UC group (p = 0.22). Mean and median knowledge levels were significantly higher in the DA group compared with the UC group for patients of all ages, tumor stage, race, family history, anxiety levels, worry about CBC, and surgery type. Eighty-six (78.9 %) of UC versus 35 (37.9 %) DA patients had low knowledge. Of patients who underwent CPM, 15 (83.3 %) in the UC cohort versus 5 (25.0 %) of DA patients had "low" knowledge.
    Knowledge was higher in the DA group. The UC group had approximately three times the number of patients of the DA group who were at risk for making a poorly informed decision to have CPM. Future studies should assess the impact of increased knowledge on overall CPM rates.
    PMID: 27654108 [PubMed - as supplied by publisher]
  • Trends and variation in the use of nipple-sparing mastectomy for breast cancer in the United States.

    Breast cancer research and treatment 2016 Nov

    Authors: Sisco M
    Abstract
    For many women, nipple-sparing mastectomy (NSM) provides aesthetic and quality-of-life outcomes superior to skin-sparing mastectomy. Accumulating data suggest that NSM provides similar oncologic outcomes in select breast cancer patients. This study sought to determine national trends in NSM use.
    Using the National Cancer Data Base, 6254 women with breast cancer who underwent NSM between 2010 and 2013 were identified. NSM rates were determined relative to the number of patients who received a mastectomy with reconstruction (n = 114,849). Associations between patient, tumor, and facility characteristics and NSM were assessed using logistic regression.
    The rate of NSM increased from 2.9 to 8.0 % between 2010 and 2013. NSM was most commonly performed in academic (adjusted odds ratio [OR] 1.43, p < 0.001) and high-volume (OR 1.59, p < 0.001) breast centers. There was up to a 5.8-fold variation in its delivery between geographic census regions (p < 0.001). Of 1231 hospitals, only 491 (39.9 %) reported performing at least one NSM during the study period. Half of all NSMs were performed by the top 6 % (n = 30) of NSM-performing centers. NSM was associated with small tumor size (p < 0.001), lower tumor grades (p < 0.05), and negative nodal status (p < 0.001). However, half of NSM patients had at least one tumor characteristic that diverged from current (2016) NCCN recommendations for the procedure.
    The use of therapeutic NSM is increasing dramatically in the United States, despite recommendations that the procedure be used with caution. As NSM becomes increasingly common, efforts are needed to monitor its long-term oncologic outcomes and to ensure equitable access to it.
    PMID: 27620883 [PubMed - as supplied by publisher]
  • Contralateral Prophylactic Mastectomy Consensus Statement from the American Society of Breast Surgeons: Additional Considerations and a Framework for Shared Decision Making.

    Annals of surgical oncology 2016 Oct

    Authors: Howard MA, Sisco M, Yao K, Winchester DJ, Barrera E, Warner J, Jaffe J, Hulick P, Kuchta K, Pusic AL, Sener SF
    Abstract
    The authors sought to study patient-reported outcomes following nipple-sparing mastectomy (NSM).
    From 2008 to 2011, the BREAST-Q was administered to women undergoing NSM surgery for cancer treatment or risk-reduction prior to surgery and at 2 years after completion of reconstruction. The change in score over time and the impact of surgical indication, complication occurrence, and laterality on scores were analyzed.
    The BREAST-Q was prospectively administered to 39 women undergoing NSM for cancer treatment (n = 17) or risk-reduction (RR) (n = 22). At 2 years after operation, median overall satisfaction with breasts was 75 (IQR = 67,100). There were significant postoperative increases in scores for overall satisfaction with breasts (+8, P = 0.021) and psychosocial well-being (+14, P = 0.003). Postoperatively, RR patients had significantly higher scores for psychosocial wellness, physical impact (chest), and overall satisfaction with outcome compared to cancer treatment patients (P < 0.05). Also, increase from preoperative to postoperative psychosocial wellness was higher in the RR compared to cancer treatment patients (+17 vs. +1, P = 0.043). Complication occurrence did not significantly impact postoperative scores.
    Following NSM for cancer treatment or RR, patients demonstrated high levels of satisfaction and quality of life as measured by BREAST-Q. Satisfaction level increased 2 years following operation. J. Surg. Oncol. 2016;114:416-422. © 2016 Wiley Periodicals, Inc.
    PMID: 27469118 [PubMed - as supplied by publisher]
  • Contralateral prophylactic mastectomy: current perspectives.

    International journal of women's health 2016

    Authors: Yao K, Sisco M, Bedrosian I
    Abstract
    There has been an increasing trend in the use of contralateral prophylactic mastectomy (CPM) in the United States among women diagnosed with unilateral breast cancer, particularly young women. Approximately one-third of women <40 years old are undergoing CPM in the US. Most studies have shown that the CPM trend is mainly patient-driven, which reflects a changing environment for newly diagnosed breast cancer patients. The most common reason that women choose CPM is based on misperceptions about CPM's effect on survival and overestimation of their contralateral breast cancer (CBC) risk. No prospective studies have shown survival benefit to CPM, and the CBC rate for most women is low at 10 years. Fear of recurrence is also a big driver of CPM decisions. Nonetheless, studies have shown that women are mostly satisfied with undergoing CPM, but complications and subsequent surgeries with reconstruction have been associated with dissatisfaction with CPM. Studies on surgeon's perspectives on CPM are sparse but show that the most common reasons surgeons discuss CPM with patients is because of a suspicious family history or for a patient who is a confirmed BRCA mutation carrier. Studies on the cost-effectiveness of CPM have been conflicting and are highly dependent on patient's quality of life after CPM. Most recent guidelines for CPM are contradictory. Future areas of research include the development of interventions to better inform patients about CPM, modification of the guidelines to form a more consistent statement, longer term studies on CBC risk and CPM's effect on survival, and prospective studies that track the psychosocial effects of CPM on body image and sexuality.
    PMID: 27382334 [PubMed - as supplied by publisher]

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