Effects of guideline adherence in primary breast cancer--a 5-year multi-center cohort study of 3976 patients.
BACKGROUND
The aim of that study was to analyze the impact of German-S3-breast cancer guideline adherence on clinical outcomes.


METHODS
A retrospective study analyzed 3976 patients first diagnosed with primary breast cancer according to an S3-guideline-based model that classified patients retrospectively into groups receiving "guideline-adherent and "guideline non-adherent" therapy.


RESULTS
There was a significant association between treatment adherence and prolonged recurrence free and overall survival (p = 0.0001). The greater the number of violations in guideline adherence, the lower was overall survival (p = 0.0001). Advanced age at initial diagnosis was additionally associated with a reduction in guideline adherence. The percentage of guideline adherence for the therapeutic modalities BCT, mastectomy, axillary dissection and hormone therapy was greater than 80%. For chemotherapy, the percent of guideline adherence totaled 71.4%.


CONCLUSIONS
Therapies dispensed in adherence with guidelines may improve recurrence-free survival and overall survival in patients with breast cancer.
Wöckel
Achim
A
Department of Gynecology and Obstetrics, University Hospital Ulm, University of Ulm Medical Center, Prittwitzstrasse 43, 89075 Ulm, Germany. achim.woeckel@uniklinik-ulm.de
Kurzeder
Christian
C
Geyer
Verena
V
Novasphenny
Igor
I
Wolters
Regine
R
Wischnewsky
Manfred
M
Kreienberg
Rolf
R
Varga
Dominic
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome