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  • Measure Summary
  • NQMC:007404
  • Jun 2010

Breast cancer: the proportion of non-invasive cancer cases for which the following prognostic/predictive parameters have been recorded: dominant histologic pattern; size in mm (best pathology or radiology estimate if 2 stage pathology); grading (according to EU Guidelines); and distance to nearest radial margin.

Del Turco MR, Ponti A, Bick U, Biganzoli L, Cserni G, Cutuli B, Decker T, Dietel M, Gentilini O, Kuehn T, Mano MP, Mantellini P, Marotti L, Poortmans P, Rank F, Roe H, Scaffidi E, van der Hage JA, Viale G, Wells C, Welnicka-Jaskiewicz M, Wengstom Y, Cataliotti L. Quality indicators in breast cancer care. Eur J Cancer. 2010 Sep;46(13):2344-56. PubMed External Web Site Policy

View the original measure documentation External Web Site Policy

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in January 2017.

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Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the proportion of non-invasive cancer cases for which the following prognostic/predictive parameters have been recorded: dominant histologic pattern; size in millimeters (best pathology or radiology estimate if 2 stage pathology); grading (according to European Union [EU] guidelines); and distance to nearest radial margin.

Rationale

Since 1990, in the United States and many European countries, breast cancer mortality is decreasing by 1% to 2% per year, thanks to early detection and improved treatment. However, it has been reported that there were still wide differences in treatment offered to patients with breast cancer in terms of mastectomy and radiotherapy rates and use of adjuvant chemotherapy and hormone therapy. It has also been shown that the specialised breast cancer care was associated with a significant reduction in mortality. Breast cancer care is complex, onerous and expensive; therefore, quality measurements are essential to monitor effectiveness and to guide improvements in healthcare.

Evidence for Rationale

Cataliotti L, Costa A, Daly PA, Fallowfield L, Freilich G, Holmberg L, Piccart M, van de Velde CJ, Veronesi U. Florence statement on breast cancer, 1998 forging the way ahead for more research on and better care in breast cancer. Eur J Cancer. 1999 Jan;35(1):14-5. [0 references] PubMed External Web Site Policy

Del Turco MR, Ponti A, Bick U, Biganzoli L, Cserni G, Cutuli B, Decker T, Dietel M, Gentilini O, Kuehn T, Mano MP, Mantellini P, Marotti L, Poortmans P, Rank F, Roe H, Scaffidi E, van der Hage JA, Viale G, Wells C, Welnicka-Jaskiewicz M, Wengstom Y, Cataliotti L. Quality indicators in breast cancer care. Eur J Cancer. 2010 Sep;46(13):2344-56. PubMed External Web Site Policy

Gillis CR, Hole DJ. Survival outcome of care by specialist surgeons in breast cancer: a study of 3786 patients in the west of Scotland. BMJ. 1996 Jan 20;312(7024):145-8. PubMed External Web Site Policy

Grilli R, Minozzi S, Tinazzi A, Labianca R, Sheldon TA, Liberati A. Do specialists do it better? The impact of specialization on the processes and outcomes of care for cancer patients. Ann Oncol. 1998 Apr;9(4):365-74. [61 references] PubMed External Web Site Policy

Sainsbury R, Rider L, Smith A, MacAdam A. Does it matter where you live? Treatment variation for breast cancer in Yorkshire. The Yorkshire Breast Cancer Group. Br J Cancer. 1995 Jun;71(6):1275-8. PubMed External Web Site Policy

Schachter HM, Mamaladze V, Lewin G, Graham ID, Brouwers M, Sampson M, Morrison A, Zhang L, O'Blenis P, Garritty C. Many quality measurements, but few quality measures assessing the quality of breast cancer care in women: a systematic review. BMC Cancer. 2006;6:291. [28 references] PubMed External Web Site Policy

Vulto JC, Louwman WJ, Poortmans PM, Lybeert LM, Rutten HJ, Coebergh JW. A population based study of radiotherapy in a cohort of patients with breast cancer diagnosed between 1996 and 2000. Eur J Cancer. 2007 Sep;43(13):1976-82. PubMed External Web Site Policy

Primary Health Components

Breast cancer (non-invasive); prognostic/predictive parameters (dominant histologic pattern, size in millimeters, grading, distance to nearest radial margin)

Denominator Description

Number of non-invasive cancer cases

Numerator Description

Number of non-invasive cancer cases for which the following prognostic/predictive parameters have been recorded: dominant histologic pattern; size in millimeters (best pathology or radiology estimate if 2 stage pathology); grading (according to European Union [EU] guidelines); and distance to nearest radial margin

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

  • Motivation: Treatment planning. In the framework of breast-conserving treatment (BCT), the tumour-free margin should ideally be measured in all directions. For BCT in ductal carcinoma in situ (DCIS), margins play probably an even more important role (together with age) as a risk factor for local recurrence (LR), compared to invasive cancer.
  • Level of evidence: II*

*Graded according to the short version of the U.S. Agency for Healthcare Research and Quality (AHRQ) classification. For more information regarding the developer's methodology, refer to the original source document.

Evidence for Additional Information Supporting Need for the Measure

Del Turco MR, Ponti A, Bick U, Biganzoli L, Cserni G, Cutuli B, Decker T, Dietel M, Gentilini O, Kuehn T, Mano MP, Mantellini P, Marotti L, Poortmans P, Rank F, Roe H, Scaffidi E, van der Hage JA, Viale G, Wells C, Welnicka-Jaskiewicz M, Wengstom Y, Cataliotti L. Quality indicators in breast cancer care. Eur J Cancer. 2010 Sep;46(13):2344-56. PubMed External Web Site Policy

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Certification

Internal quality improvement

Monitoring and planning

Measurement Setting

Ambulatory/Office-based Care

Ambulatory Procedure/Imaging Center

Hospital Inpatient

Hospital Outpatient

Professionals Involved in Delivery of Health Services

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Unspecified

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Getting Better

Living with Illness

IOM Domain

Effectiveness

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of non-invasive cancer cases

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of non-invasive cancer cases for which the following prognostic/predictive parameters have been recorded: dominant histologic pattern; size in millimeters (best pathology or radiology estimate if 2 stage pathology); grading (according to European Union [EU] guidelines); and distance to nearest radial margin

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Paper medical record

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

External comparison at a point in, or interval of, time

Internal time comparison

Prescriptive standard

Prescriptive Standard

  • Minimum standard: greater than 95%
  • Target: greater than 98%

Evidence for Prescriptive Standard

Del Turco MR, Ponti A, Bick U, Biganzoli L, Cserni G, Cutuli B, Decker T, Dietel M, Gentilini O, Kuehn T, Mano MP, Mantellini P, Marotti L, Poortmans P, Rank F, Roe H, Scaffidi E, van der Hage JA, Viale G, Wells C, Welnicka-Jaskiewicz M, Wengstom Y, Cataliotti L. Quality indicators in breast cancer care. Eur J Cancer. 2010 Sep;46(13):2344-56. PubMed External Web Site Policy

Original Title

4c: Completeness of prognostic/predictive characterisation.

Measure Collection Name

Quality Indicators in Breast Cancer Care

Submitter

European Society of Breast Cancer Specialists - Clinical Specialty Collaboration

Developer

European Society of Breast Cancer Specialists - Clinical Specialty Collaboration

Funding Source(s)

European Society of Breast Cancer Specialists (EUSOMA)

Composition of the Group that Developed the Measure

M. Rosselli Del Turco (EUSOMA, Florence, Italy); A. Ponti (CPO Piemonte, Turin, Italy); U. Bick (Charité – Universitätsmedizin Berlin, Berlin, Germany); L. Biganzoli (Hospital of Prato, Prato, Italy); G. Cserni (Bacs-Kiskun County Teaching Hospital, Kecskemét, Hungary); B. Cutuli (Policlinique de Courlancy, Reims, France); T. Decker (Dietrich Bonhoefer Clinic, Neubrandeburg, Germany); M. Dietel (Charité – Universitätsmedizin Berlin, Berlin, Germany); O. Gentilini (European Institute of Oncology, Milan, Italy); T. Kuehn (Klinikum Esslingen, Esslingen, DE, Germany); M.P. Mano (AOU San Giovanni Battista, Turin, Italy); P. Mantellini (Istituto per lo Studio e la Prevenzione Oncologica, ISPO, Florence, Italy); L. Marotti (EUSOMA, Florence, Italy); P. Poortmans (Institute Verbeeten, Tilburg, The Netherlands); F. Rank (Rigshospitalet, Copenhagen, Denmark); H. Roe (North Cumbria University Hospitals NHS Trust, Cumbria, United Kingdom); E. Scaffidi (European Institute of Oncology, Milan, Italy); J.A. van der Hage (National Cancer Institute, Amsterdam, The Netherlands); G. Viale (European Institute of Oncology and University of Milan, Milan, Italy); C. Wells (University College London Hospitals, London, United Kingdom); M. Welnicka-Jaskiewicz; (Medical University of Gdansk, Gdansk, Poland); Y. Wengstöm (Karolinska Institutet, Stockholm, Sweden); L. Cataliotti (Careggi University Hospital, Florence, Italy)

Financial Disclosures/Other Potential Conflicts of Interest

None declared.

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2010 Jun

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in January 2017.

Source(s)

Del Turco MR, Ponti A, Bick U, Biganzoli L, Cserni G, Cutuli B, Decker T, Dietel M, Gentilini O, Kuehn T, Mano MP, Mantellini P, Marotti L, Poortmans P, Rank F, Roe H, Scaffidi E, van der Hage JA, Viale G, Wells C, Welnicka-Jaskiewicz M, Wengstom Y, Cataliotti L. Quality indicators in breast cancer care. Eur J Cancer. 2010 Sep;46(13):2344-56. PubMed External Web Site Policy

Measure Availability

Source available from the European Society of Breast Cancer Specialists (EUSOMA) Web site External Web Site Policy.

For more information, contact M. Rosselli Del Turco at Email: secretariat@eusoma.org; Web site: www.eusoma.org External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on August 24, 2012. The information was verified by the measure developer on October 4, 2012.

The information was reaffirmed by the measure developer on January 9, 2017.

Copyright Statement

This article was published in the European Journal of Cancer, Vol. 46, Del Turco MR, Ponti A, Bick U, Biganzoli L, Cserni G, Cutuli B, Decker T, Dietel M, Gentilini O, Kuehn T, Mano MP, Mantellini P, Marotti L, Poortmans P, Rank F, Roe H, Scaffidi E, van der Hage JA, Viale G, Wells C, Welnicka-Jaskiewicz M, Wengstom Y, Cataliotti L, Quality indicators in breast cancer care, 2344-56, Copyright Elsevier (2010). This permission is granted for non-exclusive world English rights only. For other languages please reapply separately for each one required. Permission excludes use in a print form. Should you have a specific print project in mind please reapply for permission. Reproduction of this material is confined to the purpose for which permission is hereby given.

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