Audit system on Quality of breast cancer diagnosis and Treatment (QT): results of quality indicators on screen-detected lesions in Italy for 2006 and preliminary results for 2007.
Within this survey, conducted by the Italian Breast Screening Network (Gruppo Italiano per lo Screening Mammografico, GISMa), individual data are collected yearly on more than 50% of all screen-detected operated lesions in Italy. In 2006, results showed overall good diagnosis and treatment quality and an improving trend over time. Critical issues were identified in waiting times, compliance with recommendations on not performing frozen section examination on small lesions and on performing specimen X-ray. Pre-operative diagnosis reached the acceptable target, but there is a large variation between Regions and programmes. The sentinel lymph node technique (SLN) was performed on the axilla in more than 70% of screen-detected invasive cancers, avoiding a large number of potentially harmful dissections. On the other hand, potential overuse of SLN in ductal carcinoma in situ deserves further investigation. The detailed results have been distributed to regional and local screening programmes, also by means of an online database, in order to allow multidisciplinary discussion and the identification of appropriate solutions to any problems documented by the data. Specialist Breast Units with adequate case volume and enough resources would provide the best setting for making audit effective in producing quality improvement with a shortening of waiting times.
CPO Piemonte, Torino, Italy.
Mariano
M
Tomatis
Maria Piera
MP
Mano
Diego
D
Baiocchi
Alessandra
A
Barca
Rita
R
Bordon
Denise
D
Casella
Giovanni
G
Donati
Rosa
R
Berti
Luigi
L
Filippini
Alfonso
A
Frigerio
Alessia
A
Furini
Paola
P
Mantellini
Carlo
C
Naldoni
Giovanni
G
Pagano
Deborah
D
Ramera
Alessandra
A
Ravaioli
Anna
A
Sapino
Mario
M
Taffurelli
Marcello
M
Vettorazzi
Manuel
M
Zorzi
Luigi
L
Cataliotti
Marco
M
Rosselli Del Turco
Nereo
N
Segnan
Antonio
A
Ponti
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007558:Italy; D008197:Lymph Node Excision; D008403:Mass Screening / Q000706:statistics & numerical data*; D008485:Medical Audit / Q000706:statistics & numerical data*; D008875:Middle Aged; D019984:Quality Indicators, Health Care