title: Effects of guideline adherence in primary breast cancer--a 5-year multi-center cohort study of 3976 patients.
abstract: 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.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Ulm, University of Ulm Medical Center, Prittwitzstrasse 43, 89075 Ulm, Germany. achim.woeckel@uniklinik-ulm.de
authors.forename: Achim
authors.initials: A
authors.lastname: Wöckel
authors.forename: Christian
authors.initials: C
authors.lastname: Kurzeder
authors.forename: Verena
authors.initials: V
authors.lastname: Geyer
authors.forename: Igor
authors.initials: I
authors.lastname: Novasphenny
authors.forename: Regine
authors.initials: R
authors.lastname: Wolters
authors.forename: Manfred
authors.initials: M
authors.lastname: Wischnewsky
authors.forename: Rolf
authors.initials: R
authors.lastname: Kreienberg
authors.forename: Dominic
authors.initials: D
authors.lastname: Varga
mesh_terms: 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