title: [Audit system on quality of breast cancer diagnosis and treatment: results of quality indicators on screen-detected lesions in Italy, 2010].
abstract: This survey, conducted by the Italian breast screening network (GISMa), collects yearly individual data on diagnosis and treatment on about 50% of all screen-detected, operated lesions in Italy. The 2010 results show good overall quality 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. Preoperative diagnosis improved constantly over the years, but there is still 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 for ductal carcinoma in situ deserves further investigation. The detailed results have been distributed, also by means of a web data warehouse, to regional and local screening programmes in order to allow multidisciplinary discussion and identification of the appropriate solutions to any issues documented by the data. It should be assigned priority to the problem of waiting times. Specialist Breast Units with adequate case volume and enough resources would provide the best setting for making monitoring 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: Maria Piera
authors.initials: MP
authors.lastname: Mano
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: Denise
authors.initials: D
authors.lastname: Casella
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: Brunella
authors.initials: B
authors.lastname: Frammartino
authors.forename: Alfonso
authors.initials: A
authors.lastname: Frigerio
authors.forename: Paola
authors.initials: P
authors.lastname: Mantellini
authors.forename: Carlo
authors.initials: C
authors.lastname: Naldoni
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Orzalesi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pagano
authors.forename: Francesca
authors.initials: F
authors.lastname: Pietribiasi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ravaioli
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Sedda
authors.forename: Mario
authors.initials: M
authors.lastname: Taffurelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Cataliotti
authors.forename: Nereo
authors.initials: N
authors.lastname: Segnan
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D055088:Early Detection of Cancer / Q000592:standards*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008327:Mammography; D008403:Mass Screening / Q000592:standards*; D008485:Medical Audit; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D019984:Quality Indicators, Health Care; D021701:Sentinel Lymph Node Biopsy