Regional Variation in Performance for Commission on Cancer Breast Quality Measures and Impact on Overall Survival

Kantor, Olga; Wang, Chi‐Hsiung; Yao, Katharine

doi:10.1245/s10434-018-6592-5

Cited by 13 publications

(13 citation statements)

References 26 publications

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“…A study of high- versus low-performing regions in the US National Cancer Database did not show differences in survival. 29 However, even low-performing regions provided > 80% concordant care, and variation was slight. Stronger associations with survival might be observed in health care systems with poorer baseline performance and less access to advanced treatments.…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Care Quality in South Africa’s Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures

O’Neil

Chen

Ayeni

et al. 2019

JGO

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PURPOSEThe quality of breast cancer care in sub-Saharan Africa contributes to the region’s dismal breast cancer mortality. ASCO has issued quality measures focusing on delivery of adjuvant chemotherapy, radiotherapy, and endocrine therapy. We applied these measures in five South African public hospitals and analyzed factors associated with care concordance.MATERIALS AND METHODSAmong 1,736 women with breast cancer who were enrolled in the South African Breast Cancer and HIV Outcomes study over 24 months, we evaluated care using ASCO’s three measures. We also evaluated adjuvant chemotherapy receipt in 957 women with an indication. We used logistic regression to estimate associations between measure-concordant care and patient factors.RESULTSOf 235 women with hormone receptor–negative cancer, 173 (74%) began adjuvant chemotherapy within 120 days from diagnosis. Of 194 patients who received breast-conserving surgery, 73 (37%) began radiotherapy within 365 days from diagnosis. Of 999 women with hormone receptor–positive cancer, 719 (72%) initiated endocrine therapy within 365 days from diagnosis. Chemotherapy and radiotherapy measure-concordant care were more common among women residing < 20 km from the hospital (odds ratio [OR], 1.79; 95% CI, 1.32 to 2.44 and OR, 3.17; 95% CI, 1.57 to 6.42). Endocrine therapy measure-concordant care was more common among English-speaking women (OR, 2.12; 95% CI, 1.12 to 4.02). Participating hospitals varied in care concordance. HIV infection did not affect care quality.CONCLUSIONMore timely delivery of chemotherapy, radiotherapy, and endocrine therapy is needed in South Africa, particularly for women living > 20 km from the hospital or not speaking English. Focused quality improvement efforts could support that goal.

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Section: Discussionmentioning

confidence: 99%

Breast Cancer Care Quality in South Africa’s Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures

O’Neil

Chen

Ayeni

et al. 2019

JGO

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“…Sixty-seven papers were selected for full-text review; 64 from the electronic databases and three were selected from the reference list of an earlier systematic review [24]. Of these, 16 papers met the study eligibility criteria [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. The stages of the study selection are presented in Figure 1.…”

Section: Included Studiesmentioning

confidence: 99%

The association between guideline adherence, age and overall survival among women with non-metastatic breast cancer: A systematic review

Miller

Kreis

Gannon

et al. 2022

European Journal of Surgical Oncology

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“…The National Cancer Database showed that between 2014 and 2015, 305,391 women under 70 years of age underwent surgery as a treatment for breast cancer in the United States [5,6]. The most common breast reconstruction technique to date consists of using a 2-stage tissue expander/implant [7].…”

Section: Introductionmentioning

confidence: 99%

Postmastectomy Radiation Therapy (PMRT) before and after 2-Stage Expander-Implant Breast Reconstruction: A Systematic Review

et al. 2019

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Background: In those undergoing treatment for breast cancer, evidence has demonstrated a significant improvement in survival, and a reduction in the risk of local recurrence in patients who undergo postmastectomy radiation therapy (PMRT). There is uncertainty about the optimal timing of PMRT, whether it should be before or after tissue expander or permanent implant placement. This study aimed to summarize the data reported in the literature on the effect of the timing of PMRT, both preceding and following 2-stage expander-implant breast reconstruction (IBR), and to statistically analyze the impact of timing on infection rates and the need for explantation. Methods: A comprehensive systematic review of the literature was conducted using the PubMed/Medline, Ovid, and Cochrane databases without timeframe limitations. Articles included in the analysis were those reporting outcomes data of PMRT in IBR published from 2009 to 2017. Chi-square statistical analysis was performed to compare infection and explantation rates between the two subgroups at p < 0.05. Results: A total of 11 studies met the inclusion criteria for this study. These studies reported outcomes data for 1565 total 2-stage expander-IBR procedures, where PMRT was used (1145 before, and 420 after, implant placement). There was a statistically significant higher likelihood of infection following pre-implant placement PMRT (21.03%, p = 0.000079), compared to PMRT after implant placement (9.69%). There was no difference in the rate of explantation between pre-implant placement PMRT (12.93%) and postimplant placement PMRT (11.43%). Conclusion: This study suggests that patients receiving PMRT before implant placement in 2-stage expander–implant based reconstruction may have a higher risk of developing an infection.

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Regional Variation in Performance for Commission on Cancer Breast Quality Measures and Impact on Overall Survival

Abstract: There is significant regional variation in performance on the breast quality measures but this variation did not impact OS. Targeted efforts in certain areas of the country may help improve performance on these measures.

Cited by 13 publications

References 26 publications

Breast Cancer Care Quality in South Africa’s Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures

Breast Cancer Care Quality in South Africa’s Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures

The association between guideline adherence, age and overall survival among women with non-metastatic breast cancer: A systematic review

Postmastectomy Radiation Therapy (PMRT) before and after 2-Stage Expander-Implant Breast Reconstruction: A Systematic Review

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