Breast cancer care and surgery in Australia and New Zealand: compliance of the BreastSurgANZ quality audit with international standards. Issue 4 (1st March 2023)

• Record Type: Journal Article
• Authors: Duffield, Jaime A.; Blanch, Adam J.; Bochner, Melissa A.
• Is Part Of: ANZ journal of surgery. Volume 93:Issue 4(2023)
• Page Start: 881
• Page End: 888
• Publication Date: 2023-03-01
• Subjects: audit -- Australia -- breast cancer -- New Zealand -- quality indicator; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.18347
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: The Breast Surgeons of Australia and New Zealand (BreastSurgANZ) Quality Audit (BQA) of Breast Cancer Care is a prospective population‐based database designed for annual audit of compliance with internally derived Quality Indicators (QI)s. While there is no international consensus for QIs, audit against an external international benchmark is possible through use of QIs defined by the 2017 European Society of Breast Cancer Specialists (EUSOMA) Guidelines. Methods: BQA data from 29, 088 female patients between 1/1/2018 and 31/12/2019 were stratified by the EUSOMA definition of low‐volume hospitals (LVH <150 patients p.a.) and high‐volume hospitals (HVH ≥150 patients p.a.), and percentage compliance (±95% CI) with 14 mandatory EUSOMA QI sub‐parts were determined. Results: ANZ LVH met the quality threshold for 10, and HVH for 8 EUSOMA QI that assessed MDT, surgical approach, adjuvant radiotherapy in the LVH setting, avoidance of overtreatment, and use of endocrine therapy. ANZ did not meet the quality thresholds for QIs assessing use of neoadjuvant chemotherapy, and adjuvant radiotherapy in the HVH setting. Conclusion: Breast cancer care in ANZ is comparable with an international standard. ANZ surgeons performed at a high standard in discussion of breast cancer patients by MDT, and appropriate use of adjuvant radiotherapy by LVH. Improvements can be made in completeness of data capture, and inclusion of genetic syndrome and Ki67% in data collection. Due to the rapid evolution of breast cancer treatments, there is need for contemporary update of QI relating to the use of neoadjuvant systemic therapies. Abstract : The expression of registry data against a consistent benchmark allows comparison of breast cancer care between countries, to aid identification of inequalities, encourage improvements, and allow re‐evaluation of performance after implementation of new guidelines This manuscript presents the compliance of data from the Breast Surgeons of Australia and New Zealand (BreastSurgANZ) Quality Audit (BQA) with the breast cancer care Quality Indicators (QI)s defined by the 2017 European Society of Breast Cancer Specialists (EUSOMA) Guideline for Quality Indicators in Breast Cancer Care. We were able to demonstrate that ANZ surgeons perform at a high standard in discussion of breast cancer patients by multidisciplinary team, and that areas for improvement were in completeness of data capture, and inclusion of genetic syndrome and Ki67% in data collection. We note that due to the rapid evolution of breast cancer treatment, there is need for a contemporary update of QI relating to the use of neoadjuvant and adjuvant systemic therapies.