title: Importance of adherence to guidelines in breast cancer clinical practice. The Italian experience (AIOM).
abstract: OBJECTIVE
  Project RIGHT (Research for the Identification of the most effective and hIGHly accepted clinical guidelines for cancer Treatment) is promoted by the Italian Association of Medical Oncology (AIOM) to evaluate the concordance between AIOM breast cancer guidelines and clinical practice in Italy. In RIGHT-1, feasibility and the appropriateness of indicators were assessed in patients with early breast cancer. RIGHT-2 evaluated the compliance with guidelines in a nationwide program.
  
  
  METHODS
  Thirty-five Italian centers participated in the RIGHT-2 survey. Ten indicators were evaluated to verify an agreement between 2005 AIOM breast cancer guidelines and practice. Patients with clinical stage I-II invasive breast cancer, age ≤70 years, who had their first visit at the oncology center between October 2005 and November 2006 were included.
  
  
  RESULTS
  In RIGHT-2, ≥90% adherence for the diagnosis indicator and three therapy indicators were observed. The lowest degree of compliance (0%) was observed for the follow-up indicator in asymptomatic patients.
  
  
  CONCLUSIONS
  In RIGHT-2, compliance to the 2005 AIOM breast cancer guidelines was 64%. When the follow-up indicator was eliminated, overall adherence to AIOM guidelines was 71%. The results highlight the need to continue improving the already good standards of breast cancer care.
authors.affiliation: Oncologia Medica, Azienda Ospedaliera Treviglio-Caravaggio, Treviglio, Bergamo, Italy. sandro.barni@ospedale.treviglio.bg.it
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.forename: Marco
authors.initials: M
authors.lastname: Venturini
authors.forename: Annamaria
authors.initials: A
authors.lastname: Molino
authors.forename: Michela
authors.initials: M
authors.lastname: Donadio
authors.forename: Sara
authors.initials: S
authors.lastname: Rizzoli
authors.forename: Evaristo
authors.initials: E
authors.lastname: Maiello
authors.forename: Stefania
authors.initials: S
authors.lastname: Gori
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D002173:Cancer Care Facilities / Q000592:standards / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008495:Medical Oncology / Q000592:standards / Q000706:statistics & numerical data*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care