P A van Dam1, M Tomatis2, L Marotti3, J Heil4, R Wilson5, M Rosselli Del Turco3, C Mayr6, A Costa7, M Danei8, A Denk9, G Emons10, K Friedrichs11, N Harbeck12, M Kiechle13, U Koheler14, S Kuemmel15, N Maass16, C Marth17, A Prové18, R Kimmig19, C Rageth20, L Regolo21, L Salehi22, D Sarlos23, C Singer24, C Sohn4, G Staelens25, C Tinterri26, A Ponti2. 1. Breast Unit, Antwerp University Hospital, Edegem, Belgium. Electronic address: peter.vandam@telenet.be. 2. AOU Città della Salute e della Scienza, CPO Piemonte and EUSOMA, Data Centre, Turin, Italy. 3. EUSOMA, Florence, Italy. 4. Breast Unit, University of Heidelberg, Germany. 5. Royal Marsden Hospital, London, UK. 6. GIPMa, Comprensorio Sanitario di Bolzano, Italy. 7. Centro Senologia Multimedica Castellanza, Italy. 8. Brustcentrum am Marienhospital Aachen, Germany. 9. Brustzentrum St. Joseph-Stift Bremen, Germany. 10. Universitaets Frauenklinik Gottingen, Germany. 11. Mammazentrum Hamburg, Germany. 12. Breast Center, University of Munich (LMU), Munich, Germany. 13. Klinikum Rechts der Isar der Technischen Universitaets, Munich, Germany. 14. Breast Cancer Center "St. Georg", Leipzig, Germany. 15. Brustzentrum, Kliniken Essen Mitte, Germany. 16. University Medical Center and Luisenhospital Aachen, Germany. 17. BrustGesundheitZentrum Tirol, Innsbruck, Austria. 18. Breast Center Sint Augustinus, Wilrijk, Belgium. 19. West German Cancer Center, Breast Unit, University Clinic Essen, Germany. 20. Breast Center Zurich, Switzerland. 21. Maugeri Foundation, Pavia, Italy. 22. Breast Unit, HSK, Dr. Horst Schmidt Kliniken, Wiesbaden, Germany. 23. Brustzentrum Mittelland Kantonsspitäler Aarau/Olten, Switzerland. 24. Medical University of Vienna, Austria. 25. Borstkliniek Kortrijk AZ Groeninge, Belgium. 26. Breast Unit Humanitas Cancer Center, Rozzano, Italy.
Abstract
AIM OF THE STUDY: The European Society of Breast Cancer Specialists (EUSOMA) has fostered a voluntary certification process for breast units to establish minimum standards and ensure specialist multidisciplinary care. In the present study we assess the impact of EUSOMA certification for all breast units for which sufficient information was available before and after certification. MATERIALS AND METHODS: For 22 EUSOMA certified breast units data of 30,444 patients could be extracted from the EUSOMA database on the evolution of QI's before and after certification. RESULTS: On the average of all units, the minimum standard of care was achieved for 12/13 QI's before and after EUSOMA certification (not met for DCIS receiving just one operation). There was a significant improvement of 5 QI's after certification. The proportion of patients with invasive cancer undergoing an axillary clearance containing >9 lymph nodes (91.5% vs 89.4%, p 0.003) and patients with invasive cancer having just 1 operation (83.1% vs 80.4%, p < 0.001) dropped, but remained above the minimum standard. The targeted standard of breast care was reached for the same 4/13 QI's before and after EUSOMA certification. CONCLUSION: Although the absolute effect of EUSOMA certification was modest it further increases standards of care and should be regarded as part of a process aiming for excellence. Dedicated units already provide a high level of care before certification, but continuous monitoring and audit remains of paramount importance as complete adherence to guidelines is difficult to achieve.
AIM OF THE STUDY: The European Society of Breast Cancer Specialists (EUSOMA) has fostered a voluntary certification process for breast units to establish minimum standards and ensure specialist multidisciplinary care. In the present study we assess the impact of EUSOMA certification for all breast units for which sufficient information was available before and after certification. MATERIALS AND METHODS: For 22 EUSOMA certified breast units data of 30,444 patients could be extracted from the EUSOMA database on the evolution of QI's before and after certification. RESULTS: On the average of all units, the minimum standard of care was achieved for 12/13 QI's before and after EUSOMA certification (not met for DCIS receiving just one operation). There was a significant improvement of 5 QI's after certification. The proportion of patients with invasive cancer undergoing an axillary clearance containing >9 lymph nodes (91.5% vs 89.4%, p 0.003) and patients with invasive cancer having just 1 operation (83.1% vs 80.4%, p < 0.001) dropped, but remained above the minimum standard. The targeted standard of breast care was reached for the same 4/13 QI's before and after EUSOMA certification. CONCLUSION: Although the absolute effect of EUSOMA certification was modest it further increases standards of care and should be regarded as part of a process aiming for excellence. Dedicated units already provide a high level of care before certification, but continuous monitoring and audit remains of paramount importance as complete adherence to guidelines is difficult to achieve.
Authors: Giovanni Mauri; Luca Maria Sconfienza; Lorenzo Carlo Pescatori; Maria Paola Fedeli; Marco Alì; Giovanni Di Leo; Francesco Sardanelli Journal: Eur Radiol Date: 2017-01-03 Impact factor: 5.315
Authors: Jeffrey Landercasper; Oluwadamilola M Fayanju; Lisa Bailey; Tiffany S Berry; Andrew J Borgert; Robert Buras; Steven L Chen; Amy C Degnim; Joshua Froman; Jennifer Gass; Caprice Greenberg; Starr Koslow Mautner; Helen Krontiras; Luis D Ramirez; Michelle Sowden; Barbara Wexelman; Lee Wilke; Roshni Rao Journal: Ann Surg Oncol Date: 2017-11-22 Impact factor: 5.344
Authors: Annemie Luyckx; Leen Wyckmans; Anne-Sophie Bonte; Xuan Bich Trinh; Peter A van Dam Journal: BMC Womens Health Date: 2020-07-23 Impact factor: 2.809
Authors: L van Walle; K Punie; E Van Eycken; E de Azambuja; H Wildiers; F P Duhoux; P Vuylsteke; A Barbeaux; N Van Damme; D Verhoeven Journal: ESMO Open Date: 2021-07-14