Provider's volume and quality of breast cancer detection and treatment.
For many health conditions, the process or result of medical procedures improves with increasing caseload. The evidence about breast cancer has not been thoroughly assessed. This review synthesizes the literature about provider's volume and performance in either breast cancer screening with mammography or treatment. Articles published in English between 1990 and 2006 were identified by a computerized search and by review of reference lists. In screening with mammography, the reading volume of the radiologist and the screening volume of the facility influence different components of performance. The most conclusive evidence for breast cancer treatment concerns the association between the surgeon's caseload and the process or end-results of therapeutic interventions. Although the mechanisms of these associations still need to be clarified, large provider's volume in screening mammography or breast cancer treatment is often related to the quality of medical interventions.
Hébert-Croteau
Nicole
N
Direction des Systèmes de Soins et Services, Institut National de Santé Publique du Québec, 190 Boul. Crémazie Est, Bureau 2.24, Montréal, Quebec, Canada. Nicole.Hebert-Croteau@Inspq.qc.ca
Roberge
Danièle
D
Brisson
Jacques
J
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data; D003937:Diagnosis, Differential; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D010820:Physicians / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care / Q000706:statistics & numerical data*