title: Audit on quality of breast cancer diagnosis and treatment in Italy, 2008-2009.
abstract: This survey, conducted by the Italian breast screening network (GISMa), collects individual data yearly on about 50% of all screen-detected, operated lesions in Italy. The 2008-2009 results show good overall quality of diagnosis and treatment and an improving trend over time. Critical issues were identified, including waiting times and compliance with the recommendations on not performing frozen section examination on small lesions. Pre-operative diagnosis reached the acceptable target, but there is a large variation between regions and programmes. For almost 90% of screen-detected invasive cancers the sentinel lymph node technique (SLN) was performed on the axilla, avoiding a large number of potentially harmful dissections. On the other hand, potential overuse of SLN deserves further investigation. The detailed results have been distributed, also by means of a web-based data warehouse, to regional and local screening programmes in order to allow multidisciplinary discussion and identification of the appropriate solutions to any problem documented by the data. Specialist breast units with adequate case volume and enough resources would provide the best setting for making audits effective in producing quality improvements with shorter waiting times.
authors.affiliation: CPO Piemonte, Torino. antonio.ponti@cpo.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Ponti
authors.forename: Mariano
authors.initials: M
authors.lastname: Tomatis
authors.forename: Diego
authors.initials: D
authors.lastname: Baiocchi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Barca
authors.forename: Rosa
authors.initials: R
authors.lastname: Berti
authors.forename: Luigi
authors.initials: L
authors.lastname: Bisanti
authors.forename: Rita
authors.initials: R
authors.lastname: Bordon
authors.forename: Denise
authors.initials: D
authors.lastname: Casella
authors.forename: Carla
authors.initials: C
authors.lastname: Cogo
authors.forename: Silvia
authors.initials: S
authors.lastname: Deandrea
authors.forename: Daria
authors.initials: D
authors.lastname: Delrio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Donati
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
authors.forename: Alfonso
authors.initials: A
authors.lastname: Frigerio
authors.forename: Nico
authors.initials: N
authors.lastname: Leonardo
authors.forename: Silvia
authors.initials: S
authors.lastname: Mancini
authors.forename: Paola
authors.initials: P
authors.lastname: Mantellini
authors.forename: Carlo
authors.initials: C
authors.lastname: Naldoni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pagano
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ravaioli
authors.forename: Francesca
authors.initials: F
authors.lastname: Pietribiasi
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Sedda
authors.forename: Mario
authors.initials: M
authors.lastname: Taffurelli
authors.forename: Manuel
authors.initials: M
authors.lastname: Zorzi
authors.forename: Luigi
authors.initials: L
authors.lastname: Cataliotti
authors.forename: Nereo
authors.initials: N
authors.lastname: Segnan
authors.forename: Maria Piera
authors.initials: MP
authors.lastname: Mano
mesh_terms: D001365:Axilla / Q000601:surgery*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D055088:Early Detection of Cancer / Q000592:standards*; D005260:Female; D005629:Frozen Sections; D019983:Guideline Adherence; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008485:Medical Audit; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome