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Predictors of state-of-the-art management of early breast cancer in Switzerland


Ess, S; Joerger, M; Frick, H; Probst-Hensch, N; Vlastos, G; Rageth, C; Lütolf, U; Savidan, A; Thürlimann, B (2011). Predictors of state-of-the-art management of early breast cancer in Switzerland. Annals of Oncology, 22(3):618-624.

Abstract

Background: The aim of this study was to investigate predictors of state-of-the-art management of early breast
cancer in Switzerland.
Patients and methods: The study included 3499 women aged 25–79 years diagnosed with invasive breast cancer
stages I–IIIA in 2003–2005. Patients were identified through population-based cancer registries and treated in all kinds of settings. Concordance with national and international recommendations was assessed for 10 items covering surgery, radiotherapy, systemic adjuvant therapy and histopathology reporting. We used multivariate logistic
regression to identify independent predictors of high (10 points) and low (£7 points) concordance.
Results: In one-third of the patients, management met guidelines in all items, whereas in about one-fifth, three
or more items did not comply. Treatment by a surgeon with caseload in the upper tercile and team involved in clinical research were independent predictors of a high score, whereas treatment by a surgeon with a caseload in the lower tercile was associated with a low score. Socioeconomic characteristics such as income and education were not independent predictors, but patient’s place of residence and age independently predicted management according to recommendations.
Conclusion: Specialization and involvement in clinical research seem to be key elements for enhancing the quality of early breast cancer management at population level.

Abstract

Background: The aim of this study was to investigate predictors of state-of-the-art management of early breast
cancer in Switzerland.
Patients and methods: The study included 3499 women aged 25–79 years diagnosed with invasive breast cancer
stages I–IIIA in 2003–2005. Patients were identified through population-based cancer registries and treated in all kinds of settings. Concordance with national and international recommendations was assessed for 10 items covering surgery, radiotherapy, systemic adjuvant therapy and histopathology reporting. We used multivariate logistic
regression to identify independent predictors of high (10 points) and low (£7 points) concordance.
Results: In one-third of the patients, management met guidelines in all items, whereas in about one-fifth, three
or more items did not comply. Treatment by a surgeon with caseload in the upper tercile and team involved in clinical research were independent predictors of a high score, whereas treatment by a surgeon with a caseload in the lower tercile was associated with a low score. Socioeconomic characteristics such as income and education were not independent predictors, but patient’s place of residence and age independently predicted management according to recommendations.
Conclusion: Specialization and involvement in clinical research seem to be key elements for enhancing the quality of early breast cancer management at population level.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Pathology and Molecular Pathology
04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:15 Dec 2011 13:16
Last Modified:05 Apr 2016 15:13
Publisher:Oxford University Press
ISSN:0923-7534
Publisher DOI:https://doi.org/10.1093/annonc/mdq404
PubMed ID:20705910

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