Oluwadamilola Fayanju

Overview:

Dr. Fayanju is an Associate Professor of Surgery and Population Health Sciences in the Duke University School of Medicine, Associate Director for Disparities & Value in Healthcare with Duke Forge (the university’s center for actionable data science: https://forge.duke.edu/oluwadamilola-fayanju-md-ma-mphs), and Director of the Durham VA Breast Clinic.

She received her undergraduate degree in History and Science and an MA in Comparative Literature from Harvard. She received her MD and a master of population health sciences (MPHS) from Washington University in St. Louis, where she also completed her residency in General Surgery. She completed fellowship training in Breast Surgical Oncology at The University of Texas MD Anderson Cancer Center.

Her research, which is supported by an NIH K08 career development award, has 3 areas of focus: (1) addressing disparities in breast cancer presentation, treatment, outcome, and clinical trial participation; (2) improving prognostication and treatment for biologically aggressive variants of breast cancer that are often more common among racial and ethnic minorities; and (3) creating value in oncologic care, especially through the collection and application of patient-reported outcomes (PROs). Her scholarship has been published in a variety of journals including Annals of Surgery, Cancer, and JAMA.

She is active in several national organizations, currently serving on the Board of Directors for the Surgical Outcomes Club and on various committees including the Breast, Cancer Care Delivery, and Health Disparities Committees for the Alliance for Clinical Trials in Oncology; the Patient-reported Outcomes, Patient Safety and Quality, and Publications Committees for the American Society of Breast Surgeons (ASBrS); the Nominating and Program Committees for the Association for Academic Surgery (AAS); the Women in Surgery Committee for the Society of Black Academic Surgeons (SBAS); and the Locoregional and Patient-reported Outcomes Committees for the Translational Breast Cancer Research Consortium (TBCRC).

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:

A.B. 2001

Harvard University

M.A. 2001

Harvard University

M.D. 2007

Washington University School of Medicine

M.P.H.S. 2011

Washington University School of Medicine

General Surgery Resident, Surgery

Washington University School of Medicine

Breast Surgical Oncology Fellow, Surgery

University of Texas MD Anderson Cancer Center

Grants:

A Trial of Endocrine Response in Women with Invasive Lobular Breast Cancer

Administered By
Duke Cancer Institute
Awarded By
University of Pittsburgh
Role
Principal Investigator
Start Date
End Date

Publications:

Characterizing participants in the North Carolina Breast and Cervical Cancer Control Program: A retrospective review of 90,000 women.

BACKGROUND: The North Carolina Breast and Cervical Cancer Control Program (NC BCCCP) provides breast cancer screening services to underserved women to mitigate disparities in access to care. The authors sought to characterize this understudied population. METHODS: Women 21 years old or older who underwent their first breast cancer screen through NC BCCCP from 2008 to 2018 were included. Demographic factors associated with the timeline of care and odds of a breast cancer diagnosis were identified with negative binomial and logistic regression, respectively. RESULTS: Of the 88,893 women identified, 45.5% were non-Hispanic (NH) White, 30.9% were NH Black, 19.6% were Hispanic, 1.7% were American Indian, and 1.1% were Asian. Breast cancer was diagnosed in 2.5% of the women (n = 2255). Hispanic women were the least likely to be diagnosed with breast cancer (odds ratio vs NH White women, 0.40; 95% confidence interval [CI], 0.34-0.47). Among patients with breast pathology, the median time to diagnosis was 19 days (interquartile range [IQR], 10-33 days), and the time to treatment was 33 days (IQR, 19-54 days). After adjustments, a longer time to diagnosis was significantly associated with age (incidence rate ratio [IRR], 1.01; 95% CI, 1.01-1.02) and being NH Black (vs NH White; IRR, 1.17; 95% CI, 1.06-1.29). A longer time to treatment was significantly associated with age (IRR, 1.01; 95% CI, 1.01-1.01), being NH Black (vs NH White; IRR, 1.20; 95% CI, 1.10-1.31), and being Hispanic (vs NH White; IRR, 1.22; 95% CI, 1.05-1.41). CONCLUSIONS: NC BCCCP participants with breast cancer received treatment within approximately 1 month of presentation, and this finding aligns with quality care benchmarks. Nevertheless, racial/ethnic disparities in timeliness of care persist, and this suggests opportunities for improvement. LAY SUMMARY: This review of approximately 90,000 participants in a breast cancer screening program for uninsured and underinsured women highlights the importance of safety net programs in providing timely care to underserved patients. The authors found that the North Carolina Breast and Cervical Cancer Control Program met timeliness benchmarks from the Centers for Disease Control and Prevention across all racial/ethnic groups. However, non-Hispanic Black women experienced relative delays in the time to diagnosis, and both non-Hispanic Black women and Hispanic women experienced relative delays in the time to treatment. These findings demonstrate how racial/ethnic disparities in the timeliness of care can persist even within a program intended to reduce barriers to access.
Authors
Tait, SD; Ren, Y; Horton, CC; Oshima, SM; Thomas, SM; Wright, S; Caesar, A; Plichta, JK; Hwang, ES; Greenup, RA; Rosenberger, LH; DiLalla, GD; Menendez, CS; Tolnitch, L; Hyslop, T; Nelson, D; Fayanju, OM
MLA Citation
Tait, Sarah D., et al. “Characterizing participants in the North Carolina Breast and Cervical Cancer Control Program: A retrospective review of 90,000 women.Cancer, vol. 127, no. 14, 2021, pp. 2515–24. Pubmed, doi:10.1002/cncr.33473.
URI
https://scholars.duke.edu/individual/pub1473539
PMID
33826758
Source
pubmed
Published In
Cancer
Volume
127
Published Date
Start Page
2515
End Page
2524
DOI
10.1002/cncr.33473

Treatment Patterns and Outcomes of Women with Breast Cancer and Supraclavicular Nodal Metastases.

<h4>Background</h4>In 2002, breast cancer patients with supraclavicular nodal metastases (cN3c) were downstaged from AJCC stage IV to IIIc, prompting management with locoregional treatment. We sought to estimate the impact of multimodal therapy on overall survival (OS) in a contemporary cohort of cN3c patients.<h4>Methods</h4>Women ≥ 18 years with cT1-T4c/cN3c invasive breast cancer who underwent systemic therapy were identified from the 2004-2016 National Cancer Database. We compared three patient cohorts: (a) cN3c + multimodal therapy (systemic therapy, surgery, and radiation); (b) cN3c + non-standard therapy; and, (c) cM1. Logistic regression identified factors associated with receipt of multimodal therapy and Kaplan-Meier was used to estimate unadjusted OS. The Cox proportional hazards model estimated effects of diagnosis and treatment on OS after adjustment.<h4>Results</h4>Overall, 1827 (3.7%) patients with cN3c disease and 46,919 (96.3%) cM1 patients were identified. Of cN3c patients, 74.5% (n = 1362) received multimodal therapy and 25.5% (n = 465) received non-standard therapy; receipt of multimodal therapy was associated with improved 5-year OS (multimodal: 59% vs. M1: 28% vs. non-standard: 28%, log-rank p < 0.001). Adjusting for covariates, non-standard therapy was associated with an increased risk of death compared with receipt of multimodal therapy (HR 2.20, 95% CI 1.71-2.83, p < 0.001). Private insurance was the only patient characteristic associated with a greater likelihood of receiving multimodal therapy (OR 2.81; 95% CI, 1.64-4.82; p < 0.001).<h4>Conclusion</h4>Women with cN3c breast cancer who received multimodal therapy demonstrated improved overall survival when compared with patients undergoing non-standard therapy and those with metastatic (M1) disease. Although selection bias may contribute to worse overall survival among cN3c patients undergoing non-standard therapy, national guidelines should encourage locoregional treatment in carefully selected patients.
Authors
Tamirisa, NP; Ren, Y; Campbell, BM; Thomas, SM; Fayanju, OM; Plichta, JK; Rosenberger, LH; Force, J; Hyslop, T; Hwang, ES; Greenup, RA
MLA Citation
Tamirisa, Nina P., et al. “Treatment Patterns and Outcomes of Women with Breast Cancer and Supraclavicular Nodal Metastases.Annals of Surgical Oncology, vol. 28, no. 4, Apr. 2021, pp. 2146–54. Epmc, doi:10.1245/s10434-020-09024-1.
URI
https://scholars.duke.edu/individual/pub1460793
PMID
32946012
Source
epmc
Published In
Annals of Surgical Oncology
Volume
28
Published Date
Start Page
2146
End Page
2154
DOI
10.1245/s10434-020-09024-1

Time to surgery among women treated with neoadjuvant systemic therapy and upfront surgery for breast cancer.

PURPOSE: Time to surgery (TTS) is a potentially modifiable factor associated with survival after breast cancer diagnosis and can serve as a proxy for quality of oncologic care coordination. We sought to determine whether factors associated with delays in TTS vary between patients who receive neoadjuvant systemic therapy (NST) vs upfront surgery and whether the impact of these delays on overall survival (OS) varies with treatment sequence. METHODS: Women ≥ 18 years old with Stage I-III breast cancer were identified in the National Cancer Database (2004-2014). Multivariate linear regression stratified by treatment sequence (upfront surgery vs NST [neoadjuvant chemotherapy {NAC}, neoadjuvant endocrine therapy {NAE}, or both {NACE}]) was used to identify factors associated with TTS. Cox proportional hazards models were used to estimate the effect of TTS on overall survival (OS). RESULTS: Of 693,469 patients, 14.8% (n = 102,326) received NST (NAC n = 85,143, NAE n = 10,004, NACE n = 7179). Non-White race/ethnicity, no or government-issued insurance, more extensive surgery (i.e., mastectomy and contralateral prophylactic mastectomy vs breast-conserving surgery), and post-mastectomy reconstruction were associated with significantly longer adjusted TTS for NAC and upfront-surgery recipients, but only upfront-surgery patients had progressively worse OS with increasing TTS (> 180 vs ≤ 30 days: HR = 1.31, all p < 0.001). CONCLUSIONS: Surgery extent, race/ethnicity, and insurance were associated with TTS across treatment groups, but longer TTS was only associated with worse OS in upfront-surgery patients. Our findings can help inform surgeon-patient communication, shared decision making, care coordination, and patients' expectations throughout both NST and in the perioperative period.
Authors
MLA Citation
Prakash, Ipshita, et al. “Time to surgery among women treated with neoadjuvant systemic therapy and upfront surgery for breast cancer.Breast Cancer Res Treat, vol. 186, no. 2, Apr. 2021, pp. 535–50. Pubmed, doi:10.1007/s10549-020-06012-7.
URI
https://scholars.duke.edu/individual/pub1465190
PMID
33206290
Source
pubmed
Published In
Breast Cancer Res Treat
Volume
186
Published Date
Start Page
535
End Page
550
DOI
10.1007/s10549-020-06012-7

Patient-reported causes of distress predict disparities in time to evaluation and time to treatment after breast cancer diagnosis.

BACKGROUND: We examined whether the National Comprehensive Cancer Network distress thermometer (DT), a patient-reported outcome measure, could be used to identify levels and causes of distress associated with racial/ethnic disparities in time to care among patients with breast cancer. METHODS: We identified women aged ≥18 years with stage 0-IV breast cancer who were diagnosed in a single health system between January 2014 and July 2016. The baseline visit was defined as the first postdiagnosis, pretreatment clinical evaluation. Zero-inflated negative binomial (ZINB) regression (modeling non-zero DT scores and DT scores = 0) and logistic regression (modeling DT score ≥ 4, threshold for social services referral) were used to examine associations between baseline score (0 = none to 10 = extreme) and types of stressors (emotional, familial, practical, physical, spiritual) after adjustment for race/ethnicity and other characteristics. Linear regression with log transformation was used to identify predictors of time to evaluation and time to treatment. RESULTS: A total of 1029 women were included (median baseline DT score = 4). Emotional, physical, and practical stressors were associated with distress in both the ZINB and logistic models (all P < .05). Black patients (n = 258) were more likely to report no distress than Whites (n = 675; ZINB zero model odds ratio, 2.72; 95% CI, 1.68-4.40; P < .001) despite reporting a similar number of stressors (P = .07). Higher DT scores were associated with shorter time to evaluation and time to treatment while being Black and having physical or practical stressors were associated with delays in both (all P < .05). CONCLUSIONS: Patient-reported stressors predicted delays in time to care, but patient-reported levels of distress did not, with Black patients having delayed time to care despite reporting low levels of distress. We describe anticipatory, culturally responsive strategies for using patient-reported outcomes to address observed disparities.
Authors
Fayanju, OM; Ren, Y; Stashko, I; Power, S; Thornton, MJ; Marcom, PK; Hyslop, T; Hwang, ES
MLA Citation
Fayanju, Oluwadamilola M., et al. “Patient-reported causes of distress predict disparities in time to evaluation and time to treatment after breast cancer diagnosis.Cancer, vol. 127, no. 5, Mar. 2021, pp. 757–68. Pubmed, doi:10.1002/cncr.33310.
URI
https://scholars.duke.edu/individual/pub1464167
PMID
33175437
Source
pubmed
Published In
Cancer
Volume
127
Published Date
Start Page
757
End Page
768
DOI
10.1002/cncr.33310

Does treatment sequence affect outcomes in patients with metaplastic breast cancer?

Introduction: We compared characteristics and outcomes by treatment sequence among patients with metaplastic breast cancer (MBC), an aggressive subtype. Methods: Women ≥18 years old with newly diagnosed Stage I-III MBC from 2003 to 2018 who received any treatment in our health system were identified. Unadjusted overall survival (OS) was estimated with the Kaplan-Meier method; the log-rank test was used to compare survival differences between recipients of neoadjuvant (NACT) and adjuvant chemotherapy (ACT). Results: Of the 91 MBC patients identified, 60 received chemotherapy. NACT recipients (n = 20, median age 46.5 y) were younger than ACT recipients (n = 40, median age 60.5 y, p < 0.001) but similar with regards to race and radiation receipt. There was no significant OS difference between NACT and ACT recipients (log-rank p = 0.15), which remained true when patients were stratified by age (≥50 y vs < 50 y). Conclusions: Among MBC patients, NACT recipients were younger than ACT recipients, but there was no survival difference by treatment sequence.
Authors
Ladipo, OL; Ren, Y; Caddell, KB; Sampathkumar, A; Almond, CA; Fayanju, OM
MLA Citation
Ladipo, O. L., et al. “Does treatment sequence affect outcomes in patients with metaplastic breast cancer?American Journal of Surgery, Jan. 2021. Scopus, doi:10.1016/j.amjsurg.2021.01.007.
URI
https://scholars.duke.edu/individual/pub1473160
Source
scopus
Published In
American Journal of Surgery
Published Date
DOI
10.1016/j.amjsurg.2021.01.007