Hematology and Oncology

Breast Cancer Care in Women, Measuring Quality

October 2004

Clinical Focus*

• Question 1: What measures of the quality of care are available to assess the quality of diagnosis of breast cancer in women,including appropriate use and quality of diagnostic imaging, breast biopsy, sentinel node biopsy; appropriate use of chest x-ray, bone scan, CT scans, MRI, and blood tests; availability and accuracy of pathology staging and tumor marker status; availability, accuracy,and appropriate use of genetic testing; and patient-reported QOL and patient satisfaction?

  • 1a: In what patient populations have these quality measures been used?
  • 1b: For what diagnosis-related purposes have these quality measures been used?
  • 1c: What quality measures, if any, are available to assess differences in the quality of diagnosis of breast cancer in women related to patients' age, race, socioeconomic status, and ethnicity?

  What is the evidence supporting the use of quality measures for the diagnosis of breast cancer in women exhibited in terms of:

  • 1d: The scientific evidence demonstrating a linkage to improvement in clinical or patient reported outcomes?
  • 1e: Their psychometric performance (e.g., validity, reliability, sensitivity and specificity ceiling and floor effects)?

• Question 2: What measures of the quality of care are availableto assess the appropriate use and quality of treatment for breast cancer in women, including breast-conserving surgery; mastectomy (including adequacy of surgical margins); lymph node surgery; reconstructive surgery; radiation therapy after breast-conserving surgery and post-mastectomy; adjuvant and neoadjuvant systemictherapy (chemotherapy and hormone therapy); hormonal and chemotherapy management of metastatic disease; dosing of radiation and chemotherapy; supportive care; and patient-reported QOL and patient satisfaction?

  • 2a: In what patient populations have these quality measures been used?
  • 2b: For what treatment-related purposes have these quality measures been used?
  • 2c: What quality measures, if any, are available to assess differences in the quality of treatment of breast cancer in women related to patients' age, race, socioeconomic status, and ethnicity?

  What is the evidence supporting the use of quality measures for the treatment of breast cancer in women exhibited in terms of:

  • 2d: The scientific evidence demonstrating a linkage to improvement in clinical or patient reported outcomes?
  • 2e: Their psychometric performance (e.g., validity, reliability, sensitivity and specificity, ceiling and floor effects)?

• Question 3: What measures of the quality of care are available to assess the appropriate use and quality of followup for breast cancer in women, including patient-reported QOL and patient satisfaction?

  • 3a: In what patient populations have these quality measures been used?
  • 3b: For what followup-related purposes have these quality measures been used?
  • 3c: What quality measures, if any, are available to assess differences in the quality of followup of breast cancer in women related to patients' age, race, socioeconomic status, and ethnicity?

  What is the evidence supporting the use of quality measures for the followup of breast cancer in women exhibited in terms of:

  • 3d: The scientific evidence demonstrating a linkage to improvement in clinical or patient reported outcomes?
  • 3e: Their psychometric performance (e.g., validity, reliability, sensitivity and specificity, ceiling and floor effects)?

• Question 4: What measures are available to assess the adequacy and completeness of documentation of pathology, operative,radiation, and chemotherapy reports?

*Addressed in the summary or evidence report.

Measuring the Quality of Breast Cancer Care in Women
Summary (Publication No. 04-E030-1, September 2004)
Evidence Report (Publication No. 04-E030-2, October 2004)
(PDF Files; File Download)

EPC: University of Ottawa Evidence-based Practice Center
Topic Nominators: Centers for Medicare & Medicaid Services; Centers for Disease Control and Prevention; National Cancer Institute, NIH

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