Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2010

01-08-2010 | Healthcare Policy and Outcomes

Adherence to the National Quality Forum (NQF) Breast Cancer Measures Within Cancer Clinical Trials: A Review From ACOSOG Z0010

Authors: Lee G. Wilke, MD, Karla V. Ballman, PhD, Linda M. McCall, MS, Armando E. Giuliano, MD, Pat W. Whitworth, MD, Peter W. Blumencranz, MD, Douglas S. Reintgen, MD, William E. Burak, MD, A. Marilyn Leitch, MD, Kelly K. Hunt, MD

Published in: Annals of Surgical Oncology | Issue 8/2010

Login to get access

Abstract

Background

In 2007, the National Quality Forum (NQF) released four performance measures for the treatment of breast cancer. We proposed to study the degree of adherence with these measures among participating institutions in a multi-institutional trial.

Methods

American College of Surgeons Oncology Group (ACOSOG) Z0010 enrolled breast cancer patients onto a phase II trial studying the prognostic significance of bone marrow and sentinel node micrometastases. The current study used χ2 analyses to determine the degree of adherence with four NQF measures among three institution types: academic, community, and teaching affiliate.

Results

The study revealed small but important differences in two measures. Ninety-five percent of patients from teaching affiliated institutions received whole-breast radiation compared to 92% at academic and 91% at community hospitals. Among patients who were underinsured or uninsured, a marked decrease in radiation use was noted in comparison to patients with insurance—85 versus 93%, respectively. The study also revealed a difference among institutional types in patients undergoing excisional biopsy for diagnosis. In teaching-affiliated hospitals, 28.6% underwent excisional biopsy as compared to 36.8 and 37.4% in academic and community hospitals, respectively. There was no statistically significant difference between adherence rates with the remaining two measures. Adjuvant chemotherapy was administered to patients with hormone receptor negative tumors ≥1 cm in size in 79–85% of institutions. Tamoxifen was administered to 79–82% of those patients with hormone receptor–positive cancers.

Conclusions

Among breast cancer patients enrolled onto a multi-institutional clinical trial, we found a high degree of adherence with current consensus standards for adjuvant treatment, despite varied practice environments.
Literature
1.
2.
3.
4.
5.
Hassett MJ, Hughes ME, Niland JC, et al. Selecting high priority quality measures for breast cancer quality improvement. Med Care. 2008;46:762–70.CrossRefPubMed
6.
7.
Cheng SH, Wang CJ, Lin JL, Horng CF, Lu MC, Asch SM, et al. Adherence to quality indicators and survival in patients with breast cancer. Med Care. 2009;47:217–25.CrossRefPubMed
8.
Schacter AM, Mamaladze V, Lewin G, Graham ID, Brouwers M, Sampson M, et al. Many quality measurements, but few quality measures assessing the quality of breast cancer care in women: a systematic review. BMC Cancer. 2006;6:291.
9.
Brucker SY, Schumacher C, Sohn C, Rezai M, Bamberg M, Wallwiener D. (2008) Steering Committee. Benchmarking the quality of breast cancer care in a nationwide voluntary system: the first five-year results (2003–2007) from Germany as a proof of concept. BMC Cancer. 8:358.CrossRefPubMed
10.
Mandelblatt JS, Potosky AL. On the road to improving the quality of breast cancer care: a distance still to travel. Med Care. 2008;46:759–61.CrossRefPubMed
11.
Malin JL, Schneider EC, Epstein AM, et al. Results of the National Initiative for Cancer Care Quality. How can we improve the quality of cancer care in the United States? J Clin Oncol. 2006;24:626–33.CrossRefPubMed
12.
Desch CE, McNiff KK, Schneider EC, et al. American Society of Clinical Oncology/National Comprehensive Cancer Network quality measures. J Clin Oncol. 2008;26:3631–7.CrossRefPubMed
13.
14.
Wilke LG, McCall LM, Posther KE, et al. Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. Ann Surg Oncol. 2006;13:491–500.CrossRefPubMed
15.
Leitch AM, Beitsch PD, McCall LM, et al. Patterns of participation and successful patient recruitment to American College of Surgeons Oncology Group Z0010, a phase II trial for patients with early-stage breast cancer. Am J Surg. 2005;190:539–42.CrossRefPubMed
16.
Posther KE, McCall LM, Blumencranz PW, et al. Sentinel node skills verification and surgeon performance: data from a multicenter clinical trial for early-stage breast cancer. Ann Surg. 2005;242:593–9.PubMed
17.
18.
Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.CrossRefPubMed
19.
Veronesi U, Cascinelli N, Mariani L. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.CrossRefPubMed
20.
Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Lancet. 2005;365:1687–717.CrossRef
21.
Smith BD, Smith GL, Roberts KB, et al. Baseline utilization of breast radiotherapy before institution of the Medicare practice quality reporting initiative. Int J Radiat Oncol Biol Phys. 2009;74:1506–12.PubMed
22.
Buchholz TA, Theriault RL, Niland JC, et al. The use of radiation as a component of breast conservation therapy in National Comprehensive Cancer Network centers. J Clin Oncol. 2006;24:361–9.CrossRefPubMed
Metadata
Title
Adherence to the National Quality Forum (NQF) Breast Cancer Measures Within Cancer Clinical Trials: A Review From ACOSOG Z0010
Authors
Lee G. Wilke, MD
Karla V. Ballman, PhD
Linda M. McCall, MS
Armando E. Giuliano, MD
Pat W. Whitworth, MD
Peter W. Blumencranz, MD
Douglas S. Reintgen, MD
William E. Burak, MD
A. Marilyn Leitch, MD
Kelly K. Hunt, MD
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 8/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-0980-9

Other articles of this Issue 8/2010

Annals of Surgical Oncology 8/2010 Go to the issue

Hepatobiliary Tumors

Laparoscopic Right Hemihepatectomy for Hepatocellular Carcinoma

Translational Research and Biomarkers

Biobanking of Human Pancreas Cancer Tissue: Impact of Ex-Vivo Procurement Times on RNA Quality

Thoracic Oncology

Risk of Varices Bleeding after Spleen-Preserving Distal Pancreatectomy with Excision of Splenic Artery and Vein

Translational Research and Biomarkers

Epigenetic Inactivation of the Thyroid Hormone Receptor β1 Gene at 3p24.2 in Lung Cancer

Melanomas

Sentinel Node Positive Melanoma Patients: Prediction and Prognostic Significance of Nonsentinel Node Metastases and Development of a Survival Tree Model

Breast Oncology

Incidental Breast Lesions Identified by 18F-Fluorodeoxyglucose-Positron Emission Tomography