Quality Assured Health Care in Certified Breast Centers and Improvement of the Prognosis of Breast Cancer Patients

Abstract

Background: Increasing effort has been put in the implementation and certification of breast centers in order to establish standardized, quality assured health care for breast cancer patients. The aim of this analysis was to investigate whether patients treated in certified breast centers (CBC) have a favorable prognosis as compared to patients treated outside of certified breast treatment units. Patients and Methods: The data of 3,940 patients with invasive nonmetastatic breast cancer were analyzed with regard to differences in patient and tumor characteristics and crude overall survival according to diagnosis in or outside CBC in Middle Franconia, Germany. Patient, tumor, and follow-up data were obtained from the clinical cancer registry. Results: Patients in CBC were younger, and had lower disease stages and lower grading. Independent of the effects of these variables on overall survival, being treated at a CBC added to the prediction of overall survival. Patients treated at a CBC had a hazard ratio of 0.70 (95% confidence interval 0.52–0.93) in the adjusted Cox model. Conclusions: Independent from common prognostic factors, diagnosis and treatment of breast cancer at a CBC improves the prognosis of patients. It can be hypothesized that this effect is mediated through quality assured health care provided by the certification process.

Single-Source Tumor Documentation - Reusing Oncology Data for Different Purposes

“…The latter was defined as the joint set of basis tumordocumentationoftheWorkingGroupofGermanTumorcenters (AbeitsgemeinschaftDeutscherTumorzentren,ADT),thedatasetofthe SocietyofEpidemiologicalCancerRegistries(GesellschaftderepidemiologischenKrebsregisterinDeutschland,GEKID)andtheBavariancancer registrylaw(BCRL).Wealsoidentified16differentEuropeanandGer-man quality assurance and certification initiatives; within the CCC-EN context we focused on the German national quality insurance program and the 10 certificates of the German Cancer Association (Deutsche Krebsgesellschaft,DKG) [12].…”

Economic Constraints - the Growing Challenge for Western Breast Cancer Centers

“…In Germany, certified Breast Cancer Centers offer high-quality medical care, and a recent publication suggest an overall positive impact on survival when being treated in a Breast Cancer Center [7]. This substantiates the hypothesis that this effect is the result of quality-assured healthcare implemented and controlled by the certification process [3]. Landercasper and Tafra [16] identified in their work processes of care with either an inverse or a direct relationship between quality and cost.…”

“…A recent analysis of 3,940 patients suffering from invasive non-metastatic breast cancer explored the prognostic impact of being diagnosed and treated inside or outside of certified Breast Cancer Centers. Apart from common prognostic factors like age, disease stages and grading, being diagnosed and treated in certified Breast Cancer Centers turned out to be an independent prognostic factor with a hazard ratio of 0.7 [3]. The development and maintenance of these standardized and certified Breast Cancer Centers is time-consuming and costly.…”

Indicadores de calidad en cáncer de mama

“…También nos parece importante definir a nivel de la Sociedad de Mastología, estándares mínimos y óptimos que permitan inicialmente que cada centro se autoevalúe para en un futuro plantear la necesidad de acreditación [8][9][10][11][12][13][14][15][16][17] .…”