title: Audit system on Quality of breast cancer diagnosis and Treatment (QT): results of quality indicators on screen-detected lesions in Italy, 2011-2012.
abstract: This annual survey, conducted by the Italian group for mammography screening (GISMa), collects individual data on diagnosis and treatment of about 50% of screen-detected, operated lesions in Italy. The 2011-2012 results show good overall quality and an improving trend over time. A number of critical issues have been identified, including waiting times (which have had a worsening trend over the years) and compliance with the recommendation of not performing frozen section examination on small lesions. Pre-operative diagnosis improved constantly over time, but there is still a large variation between Regions and programmes. For almost 90% of screen-detected invasive cancers a sentinel lymph node (SLN) biopsy was performed on the axilla, avoiding a large number of potentially harmful dissections. On the other hand, potential overuse of SLN dissection for ductal carcinoma in situ, although apparently starting to decline, deserves further investigation. The detailed results have been distributed, among other ways 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 issues documented by the data. The problem of waiting times should be assigned priority. 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, AOU Città della salute e della scienza, 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: Denise
authors.initials: D
authors.lastname: Casella
authors.forename: Enrico
authors.initials: E
authors.lastname: D'Ambrosio
authors.forename: Erika
authors.initials: E
authors.lastname: Delos
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: Fabiola
authors.initials: F
authors.lastname: Giudici
authors.forename: Paola
authors.initials: P
authors.lastname: Mantellini
authors.forename: Carlo
authors.initials: C
authors.lastname: Naldoni
authors.forename: Carlo
authors.initials: C
authors.lastname: Olla Atzeni
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: Sabina
authors.initials: S
authors.lastname: Pitarella
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ravaioli
authors.forename: Anna
authors.initials: A
authors.lastname: Silvestri
authors.forename: Mario
authors.initials: M
authors.lastname: Taffurelli
authors.forename: Enrica
authors.initials: E
authors.lastname: Tidone
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Zanconati
authors.forename: Nereo
authors.initials: N
authors.lastname: Segnan
mesh_terms: D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000628:therapy*; D055088:Early Detection of Cancer; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy; D008327:Mammography; D008403:Mass Screening; D008485:Medical Audit; D008875:Middle Aged; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D013997:Time Factors