BACKGROUND: National Comprehensive Cancer Network (NCCN) guideline compliance for breast cancer was determined in a breast center. METHODS: A retrospective study of 200 new breast cancer patients seen in 2004 was performed. RESULTS: NCCN guideline compliance rates for preoperative evaluation, breast surgery, lymph node surgery, radiation treatment, and systemic adjuvant therapy were 87%, 97%, 97%, 77%, and 63%, respectively. The most common reasons for noncompliance were partial breast radiation, no radiation, limited life expectancy, and patient choice to defer systemic treatment. CONCLUSIONS: The investigation of quality of breast cancer care requires measurement of compliance and reasons for noncompliance with established guidelines. A review that focuses only on percentage compliance has the potential to penalize institutions that (1) practice informed consent detailing absolute risks of survival with and without systemic therapy, (2) practice evidence-based medicine before the standardized guideline is changed to reflect it, and (3) serve populations with limited life expectancy.
BACKGROUND: National Comprehensive Cancer Network (NCCN) guideline compliance for breast cancer was determined in a breast center. METHODS: A retrospective study of 200 new breast cancerpatients seen in 2004 was performed. RESULTS: NCCN guideline compliance rates for preoperative evaluation, breast surgery, lymph node surgery, radiation treatment, and systemic adjuvant therapy were 87%, 97%, 97%, 77%, and 63%, respectively. The most common reasons for noncompliance were partial breast radiation, no radiation, limited life expectancy, and patient choice to defer systemic treatment. CONCLUSIONS: The investigation of quality of breast cancer care requires measurement of compliance and reasons for noncompliance with established guidelines. A review that focuses only on percentage compliance has the potential to penalize institutions that (1) practice informed consent detailing absolute risks of survival with and without systemic therapy, (2) practice evidence-based medicine before the standardized guideline is changed to reflect it, and (3) serve populations with limited life expectancy.
Authors: Ian K Komenaka; Chiu-Hsieh Hsu; Maria Elena Martinez; Marcia E Bouton; Boo Ghee Low; Jason A Salganick; Jesse Nodora; Michael L Hibbard; Chandra Jha Journal: Oncologist Date: 2011-05-09
Authors: Stanimira Krotneva; Kristen Reidel; Mohammed Nassif; Nora Trabulsi; Nancy Mayo; Robyn Tamblyn; Ari N Meguerditchian Journal: Breast Cancer Res Treat Date: 2013-07-24 Impact factor: 4.872
Authors: Jessica P Hwang; Michael J Fisch; Anna S-F Lok; Hong Zhang; John M Vierling; Maria E Suarez-Almazor Journal: BMC Cancer Date: 2013-11-09 Impact factor: 4.430
Authors: Mia Bierbaum; Jeffrey Braithwaite; Gaston Arnolda; Geoffrey P Delaney; Winston Liauw; Richard Kefford; Yvonne Tran; Bróna Nic Giolla Easpaig; Frances Rapport Journal: BMJ Open Date: 2020-03-23 Impact factor: 2.692