Breast cancer care: changing community standards.
A community hospital-based program was developed to improve breast cancer care in the community. A consensus was developed for what should be optimal care; a database was established to document the care being delivered in the community; and the data were analyzed to document changes in practice patterns over time. The major clinical benefits to patients included a significant improvement in needle biopsy rates, decreased utilization of second operative procedures, increased breast conservation surgery, conformity to guidelines for adjuvant chemotherapy administration, and a sizable increase in discovery of small breast cancers by screening mammography.
South Carolina Cancer Center, Columbia, USA. wbutler@sconcology.net
William M
WM
Butler
Joan E
JE
Cunningham
Douglas
D
Bull
Tommy
T
Cupples
Paul
P
Guerry
James C
JC
Reynolds
C Alden
CA
Sweatman
D001707:Biopsy, Needle / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D019090:Case Management; D017024:Chemotherapy, Adjuvant / Q000592:standards; D019992:Databases as Topic; D005260:Female; D006764:Hospitals, Community / Q000458:organization & administration / Q000592:standards*; D006784:Hospitals, Teaching; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data; D016522:Oncology Service, Hospital / Q000458:organization & administration / Q000592:standards*; D010818:Practice Patterns, Physicians'; D016730:Program Development; D012086:Reoperation; D013022:South Carolina; D017749:Total Quality Management / Q000458:organization & administration*; D014932:Women's Health Services / Q000458:organization & administration / Q000592:standards*