title: French Medico-Administrative Data to Identify the Care Pathways of Women With Breast Cancer.
abstract: Study of the care pathways is an important topic for care planning, as well as to observe guidelines application. This study aimed to describe care pathways and the period of time between treatments of women with breast cancer (BC), at a population level.
  
  
  
  Women with in situ, local and regional BC who were hospitalized and newly treated in 2012 were included and followed for 1 year. Care pathways were described, focusing on surgery (partial mastectomy [PM], total mastectomy [TM]), chemotherapy, and radiotherapy. The periods of time between treatments were measured and compared with the guidelines.
  
  
  
  The study involved 52,128 women. The most common care pathways among the 2845 women with in situ BC were PM-radiotherapy (46.7%) and TM (28.5%). Among the 41,470 women with local BC, they were: PM-radiotherapy (44.8%) or PM-chemotherapy-radiotherapy (16.0%). The 7813 women with regional BC had similar care pathways, although chemotherapy was given more frequently (73%). The periods of time between surgery and chemotherapy were in accordance with the guidelines for 98% of the women; those between surgery and radiotherapy were affected by adjuvant chemotherapy. Finally, the time between chemotherapy and radiotherapy was longer than recommended for 40% of the women.
  
  
  
  The French medicoadministrative databases allow the study, at a national population level, of the care pathways and periods of time between treatments of women with BC according to the stage of the disease. They were close to the guidelines, although an improvement is highly necessary.
authors.affiliation: Observation, Survey and Assessment Department, Institut National du Cancer, Boulogne-Billancourt, France. Electronic address: dlefeuvre@institutcancer.fr.
authors.forename: Delphine
authors.initials: D
authors.lastname: Lefeuvre
authors.affiliation: Observation, Survey and Assessment Department, Institut National du Cancer, Boulogne-Billancourt, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Le Bihan-Benjamin
authors.affiliation: Clinical Trial Department, Institut National du Cancer, Boulogne-Billancourt, France.
authors.forename: Iris
authors.initials: I
authors.lastname: Pauporté
authors.affiliation: Paris Descartes University, Paris, France; Medical Oncology Department, Georges Pompidou European Hospital, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Medioni
authors.affiliation: Observation, Survey and Assessment Department, Institut National du Cancer, Boulogne-Billancourt, France.
authors.forename: Philippe-Jean
authors.initials: PJ
authors.lastname: Bousquet
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D019091:Critical Pathways; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009313:National Health Programs; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies
keywords: Breast cancer; Care pathways; Diagnosis-related groups database; Population level; Time between treatments