Quality indicators for the diagnosis and treatment of breast cancer integrated assistanceA critical appraisal (Pag. -e 102067)

  1. M. Maes-Carballo 1
  2. M. Martín-Díaz 2
  3. L. Mignini 3
  4. K.S. Khan 3
  5. R. Trigueros 4
  6. A. Bueno-Cavanillas 3
  1. 1 Complexo Hospitalario Universitario de Ourense
    info

    Complexo Hospitalario Universitario de Ourense

    Orense, España

    ROR https://ror.org/04f1y4a64

  2. 2 Hospital Santa Ana de Motril, Spain
  3. 3 University of Granada, Spain
  4. 4 University of Almeria, Spain
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Journal:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Year of publication: 2024

Issue: 1

Pages: 6-6

Type: Article

DOI: 10.1016/J.SEMERG.2023.102067 DIALNET GOOGLE SCHOLAR

More publications in: Semergen: revista española de medicina de familia

Abstract

Introduction Quality indicators (QIs) are essential for adequate control of the health care management process, recognizing areas of improvement and providing solutions. We aimed to evaluate the Integrated Breast Cancer (BC) Care Process QIs. Methods We studied 487 consecutive BC cases diagnosed from November 1st, 2013, to November 30th, 2019, in a Spanish healthcare area, and we estimated the associated QIs. Results Four indicators did not meet the standards and were analysed based on related sociodemographic and clinical variables. The surgical delay after a multidisciplinary team discussion (mean 64%, IQR 59.6–68.5) was lower in elder people (p = 0.027), and early histological grades (p = 0.019) and stages (p = 0.008). The adjuvant treatment delay (mean 55.7%, IQR 51.1–60.3) was lower in advance stages (p = 0.002) and when there was no reoperation (p = 0.001). The surgical delay after inclusion (mean 83.2%, IQR 79.3–87.2) was lower in early histological grades (p = 0.048). The immediate reconstruction (mean 42.3%, IQR 34.0–50.5) reached 72.3% in young women compared to 11.8% in older than 70 years (p = 0.001) and it was higher in early stages (45.3% vs 36.2%; p = 0.049). Conclusion The study of QIs evaluated their compliance and analysed the variables influencing them to propose improvement measures. Not all the indicators were equally valuable. Some depended on the available resources, and others on the mix of patients or complementary treatments. It would be essential to identify the specific target populations to estimate the indicators or provide standards stratified by the related variables.

Bibliographic References

  • M. Acebal Blanco, E. Alba Conejo, M. Alvarez Benito, E. Bayo Lozano, S. Del Río Urenda, M. Dotor Gracia Cáncer de mama: proceso asistencial integrado[[Breast cancer: integrated breast cancer process]] (3ª ed.), Consejería de Salud, Sevilla (2011) Google Scholar
  • A.G. Waks, E.P. Winer Breast cancer treatment: a review JAMA, 321 (2019), pp. 288-300, 10.1001/jama.2018.19323 [published online first] View article View in ScopusGoogle Scholar
  • C.W.H. Chan, B.M.H. Law, W.K.W. So, K.M. Chow, M.M.Y. Waye Novel strategies on personalized medicine for breast cancer treatment: an update Int J Mol Sci, 18 (2017), 10.3390/ijms18112423 [published online first] View article Google Scholar
  • K.B. Clough, R.F.D. van la Parra, H.H. Thygesen, E. Levy, E. Russ, N.M. Halabi, et al. Long-term results after oncoplastic surgery for breast cancer: a 10-year follow-up Ann Surg, 268 (2018), pp. 165-171, 10.1097/SLA.0000000000002255 [published online first] View articleView in ScopusGoogle Scholar
  • A.K. Alderman, Y. Wei, J.D. Birkmeyer Use of breast reconstruction after mastectomy following the Women's Health and Cancer Rights Act JAMA, 295 (2006), pp. 387-388, 10.1001/jama.295.4.387 [published online first] View article View in ScopusGoogle Scholar
  • E.C. Inwald, M. Klinkhammer-Schalke, M. Koller, O. Ortmann Quality assurance for patients with breast cancer – the impact of clinical cancer registries Geburtsh Frauenheilk, 74 (2014), pp. 868-874 View PDF This article is free to access. View in ScopusGoogle Scholar
  • M. Acebal Blanco, E. Alba Conejo, M. Alvarez Benito, E. Bayo Lozano, S. Del Río Urenda, M. Dotor Gracia Cáncer de mama: proceso asistencial integrado (3ª ed.), Consejería de Salud, Sevilla (2011) Google Scholar
  • L. Biganzoli, L. Marotti, C.D. Hart, L. Cataliotti, B. Cutuli, T. Kühn, et al. Quality indicators in breast cancer care: an update from the EUSOMA working group Eur J Cancer, 86 (2017), pp. 59-81, 10.1016/j.ejca.2017.08.017 [published online first] View PDF Your institution provides access to this article. View in ScopusGoogle Scholar
  • C.E.M.K. Desch, E.C. Schneider, D. Schrag, J. McClure, E. Lepisto American Society of Clinical Oncology/National Comprehensive Cancer Network Quality Measures J Clin Oncol, 26 (2008), pp. 3631-3637 View in ScopusGoogle Scholar
  • A. Donabedian Evaluating the quality of medical care Milbank Mem Fund Q, 44 (Suppl.) (1966), pp. 166-206 View article CrossRefView in ScopusGoogle Scholar
  • S.M.B.J. Campbell, A. Hutchinson, M. Marshall Research methods used in developing and applying quality indicators in primary care BMJ, 326 (2003), pp. 816-819, 10.1136/qhc.11.4.358 [published online first] View article View in ScopusGoogle Scholar
  • N. Sripaiboonkij, B. Thinkamrop, S. Promthet, K. Chalermdej, V. Tangcharoensathien, T. Ansusing, et al. Breast cancer detection rate, incidence, prevalence and interval cancer-related mammography screening times among Thai women Asian Pac J Cancer Prev, 17 (2016), pp. 4137-4141 Google Scholar
  • M.L. Zhang, Z.Z. Huang, Y. Zheng Estimates and prediction on incidence, mortality and prevalence of breast cancer in China, 2008 Zhonghua Liu Xing Bing Xue Za Zhi, 33 (2012), pp. 1049-1051 View in ScopusGoogle Scholar
  • Y. Wang, J. Liu, W. Jia, S. Li, N. Rao, F. Su, et al. Comparison of the therapeutic efficacy of the early and the delayed use of vinorelbine-based regimens for patients with advanced breast cancer Chemotherapy, 62 (2017), pp. 71-79, 10.1159/000448472 [published online first] View article Google Scholar
  • M. Rezai, S. Knispel, S. Kellersmann, H. Lax, R. Kimmig, P. Kern Systematization of oncoplastic surgery: selection of surgical techniques and patient-reported outcome in a cohort of 1,035 patients Ann Surg Oncol, 22 (2015), pp. 3730-3737, 10.1245/s10434-015-4396-4 [published online first] View PDF Your institution provides access to this article. View in ScopusGoogle Scholar
  • A.S.H. Lee Why is carcinoma of the breast more frequent in the upper outer quadrant? Breast, 14 (2005), pp. 151-152, 10.1016/j.breast.2004.07.002 [published online first] View article View in ScopusGoogle Scholar
  • A. Jimenez-Puente, J.C. Maanon-di Leo, A. Lara-Blanquer Breast reconstruction post-mastectomy in the public health system of Andalusia, Spain Rev Esp Salud Publica, 90 (2016), p. E4 View in ScopusGoogle Scholar
  • V.L. Negenborn, J.H. Volders, N.M.A. Krekel, M.H. Haloua, M.B. Bouman, M.E. Buncamper, et al. Breast-conserving therapy for breast cancer: cosmetic results and options for delayed reconstruction J Plast Reconstr Aesthet Surg, 70 (2017), pp. 1336-1344, 10.1016/j.bjps.2017.05.005 [published online first] View PDF Your institution provides access to this article. View in ScopusGoogle Scholar
  • H.S. Cody 3rd, K.J. Van Zee Reexcision – the other breast cancer epidemic N Engl J Med, 373 (2015), pp. 568-569, 10.1056/NEJMe1507190 [published online first] View article View in ScopusGoogle Scholar
  • P. Saip, S. Keskin, M. Ozkan, M.A. Kaplan, F. Aydogan, G. Gonullu-Demirag, et al. The access rate to diagnosis and treatment modalities in breast cancer patients in Turkey: multicenter observational study J BUON, 16 (2011), pp. 664-671 View in ScopusGoogle Scholar
  • B.J. Adams, C.K. Zoon, C. Stevenson, P. Chitnavis, L. Wolfe, H.D. Bear The role of margin status and reexcision in local recurrence following breast conservation surgery Ann Surg Oncol, 20 (2013), pp. 2250-2255, 10.1245/s10434-012-2831-3 [published online first] View PDF Your institution provides access to this article. View in ScopusGoogle Scholar
  • A. Klit, T.F. Tvedskov, N. Kroman, J.J. Elberg, B. Ejlertsen, T.F. Henriksen Oncoplastic breast surgery does not delay the onset of adjuvant chemotherapy: a population-based study Acta Oncol, 56 (2017), pp. 719-723, 10.1080/0284186X.2017.1281437 [published online first] View PDF This article is free to access. View in ScopusGoogle Scholar
  • C.R. Albornoz, P.G. Cordeiro, A.L. Pusic, C.M. McCarthy, B.J. Mehrara, J.J. Disa, et al. Diminishing relative contraindications for immediate breast reconstruction: a multicenter study J Am Coll Surg, 219 (2014), pp. 788-795, 10.1016/j.jamcollsurg.2014.05.012 [published online first] View article View in ScopusGoogle Scholar
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