Jennifer Plichta

Positions:

Associate Professor of Surgery

Surgical Oncology
School of Medicine

Associate Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.A. 2002

Depauw University

M.D. 2008

Indiana University, School of Medicine

M.S. 2012

Loyola University Medical Center

General Surgery Resident, Surgery

Loyola University Medical Center

Breast Surgery Fellowship, Surgery

Brigham and Women's Hospital

Breast Surgery Fellowship, Surgery

Dana-Farber Cancer Institute

Breast Surgery Fellowship, Surgery

Massachusetts General Hospital

Grants:

Publications:

Genetic Counseling and Testing in African American Patients With Breast Cancer: A Nationwide Survey of US Breast Oncologists.

<h4>Purpose</h4>To determine if physicians' self-reported knowledge, attitudes, and practices regarding genetic counseling and testing (GCT) vary by patients' race.<h4>Methods</h4>We conducted a nationwide 49-item survey among breast oncology physicians in the United States. We queried respondents about their own demographics, clinical characteristics, knowledge, attitudes, practices, and perceived barriers in providing GCT to patients with breast cancer.<h4>Results</h4>Our survey included responses from 277 physicians (females, 58.8%; medical oncologists, 75.1%; academic physicians, 61.7%; and Whites, 67.1%). Only 1.8% indicated that they were more likely to refer a White patient than refer an African American patient for GCT, and 66.9% believed that African American women with breast cancer have lower rates of GCT than White women. Regarding perceived barriers to GCT, 63.4% of respondents indicated that African American women face more barriers than White women do and 21% felt that African American women require more information and guidance during the GCT decision-making process than White women. Although 32% of respondents indicated that lack of trust was a barrier to GCT in all patients, 58.1% felt that this was a greater barrier for African American women (<i>P</i> < .0001). Only 13.9% believed that noncompliance with GCT is a barrier for all patients, whereas 30.6% believed that African American women are more likely than White women to be noncompliant (<i>P</i> < .0001).<h4>Conclusion</h4>We demonstrated that racial differences exist in oncology physicians' perceived barriers to GCT for patients with breast cancer. This nationwide survey will serve as a basis for understanding physicians' determinants of GCT for African American women and highlights the necessity of education and interventions to address bias among physicians. Awareness of such physician biases can enable further work to address inequities, ultimately leading to improved GCT equity for African American women with breast cancer.
Authors
Ademuyiwa, FO; Salyer, P; Tao, Y; Luo, J; Hensing, WL; Afolalu, A; Peterson, LL; Weilbaecher, K; Housten, AJ; Baumann, AA; Desai, M; Jones, S; Linnenbringer, E; Plichta, J; Bierut, L
MLA Citation
Ademuyiwa, Foluso O., et al. “Genetic Counseling and Testing in African American Patients With Breast Cancer: A Nationwide Survey of US Breast Oncologists.Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, Oct. 2021, p. JCO2101426. Epmc, doi:10.1200/jco.21.01426.
URI
https://scholars.duke.edu/individual/pub1499387
PMID
34662201
Source
epmc
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Published Date
Start Page
JCO2101426
DOI
10.1200/jco.21.01426

Disparities in Genetic Testing for Heritable Solid-Tumor Malignancies

Authors
Dillon, J; Ademuyiwa, FO; Barrett, M; Moss, HA; Wignall, E; Menendez, C; Hughes, KS; Plichta, JK
MLA Citation
Dillon, J., et al. “Disparities in Genetic Testing for Heritable Solid-Tumor Malignancies.” Surgical Oncology Clinics of North America, Jan. 2021. Scopus, doi:10.1016/j.soc.2021.08.004.
URI
https://scholars.duke.edu/individual/pub1499629
Source
scopus
Published In
Surgical Oncology Clinics of North America
Published Date
DOI
10.1016/j.soc.2021.08.004

Mortality in Older Patients with Breast Cancer Undergoing Breast Surgery: How Low is "Low Risk"?

BACKGROUND: Breast surgery carries a low risk of postoperative mortality. For older patients with multiple comorbidities, even low-risk procedures can confer some increased perioperative risk. We sought to identify factors associated with postoperative mortality in breast cancer patients ≥70 years to create a nomogram for predicting risk of death within 90 days. METHODS: Patients diagnosed with nonmetastatic invasive breast cancer (2010-2016) were selected from the National Cancer Database. Unadjusted OS was estimated using the Kaplan-Meier method. Multivariate logistic regression was used to estimate the association of age and surgery with 90-day mortality and to build a predictive nomogram. RESULTS: Among surgical patients ≥70 years, unadjusted 90-day mortality increased with increasing age (70-74 = 0.4% vs. ≥85 = 1.6%), comorbidity score (0 = 0.5% vs. ≥3 = 2.7%), and disease stage (I = 0.4% vs. III = 2.7%; all p < 0.001). After adjustment, death within 90 days of surgery was associated with higher age (≥85 vs. 70-74: odds ratio [OR] 3.16, 95% confidence interval [CI] 2.74-3.65), comorbidity score (≥3 vs. 0: OR 4.79, 95% CI 3.89-5.89), and disease stage (III vs. I: OR 4.30, 95% CI 3.69-5.00). Based on these findings, seven variables (age, gender, comorbidity score, facility type, facility location, clinical stage, and surgery type) were selected to build a nomogram; estimates of risk of death within 90 days ranged from <1 to >30%. CONCLUSIONS: Breast operations remain relatively low-risk procedures for older patients with breast cancer, but select factors can be used to estimate the risk of postoperative mortality to guide surgical decision-making among older women.
MLA Citation
Dillon, Jacquelyn, et al. “Mortality in Older Patients with Breast Cancer Undergoing Breast Surgery: How Low is "Low Risk"?Ann Surg Oncol, vol. 28, no. 10, 2021, pp. 5758–67. Pubmed, doi:10.1245/s10434-021-10502-3.
URI
https://scholars.duke.edu/individual/pub1483069
PMID
34309779
Source
pubmed
Published In
Annals of Surgical Oncology
Volume
28
Published Date
Start Page
5758
End Page
5767
DOI
10.1245/s10434-021-10502-3

Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.

<h4>Background</h4>Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery.<h4>Methods</h4>This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models.<h4>Results</h4>Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas.<h4>Conclusion</h4>Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas.
Authors
COVIDSurg Collaborative,
MLA Citation
COVIDSurg Collaborative, Christopher S. “Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.The British Journal of Surgery, vol. 108, no. 1, Jan. 2021, pp. 88–96. Epmc, doi:10.1093/bjs/znaa051.
URI
https://scholars.duke.edu/individual/pub1481716
PMID
33640908
Source
epmc
Published In
British Journal of Surgery
Volume
108
Published Date
Start Page
88
End Page
96
DOI
10.1093/bjs/znaa051

Breast cancer prognostic staging and internal mammary lymph node metastases: a brief overview.

Authors
MLA Citation
Plichta, Jennifer K. “Breast cancer prognostic staging and internal mammary lymph node metastases: a brief overview.Chin Clin Oncol, vol. 8, no. S1, Oct. 2019, p. S11. Pubmed, doi:10.21037/cco.2019.01.09.
URI
https://scholars.duke.edu/individual/pub1483721
PMID
31684732
Source
pubmed
Published In
Chin Clin Oncol
Volume
8
Published Date
Start Page
S11
DOI
10.21037/cco.2019.01.09