Multidisciplinary team meeting and EUSOMA quality indicators in breast cancer care: A French regional multicenter study

We evaluate breast cancer (BC) pathway at a regional level including public, private and university institutions. We assessed the quality of multidisciplinary team meetings (MTM) and compliance with a panel of European high-quality indicators (EUSOMA QIs). We conducted a retrospective multicenter (n...

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Bibliographic Details
Published in:	Breast (Edinburgh) Vol. 46; pp. 170 - 177
Main Authors:	Pons-Tostivint, E., Daubisse-Marliac, L., Grosclaude, P., Oum sack, E., Goddard, J., Morel, C., Dunet, C., Sibrac, L., Lagadic, C., Bauvin, E., Bergé, Y., Bernard-Marty, C., Vaysse, C., Lacaze, J.L.L.
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Ltd 01-08-2019 Elsevier
Subjects:	Adult Breast Neoplasms Cancer care pathway Critical Pathways - standards Early breast cancer EUSOMA quality indicators Female France Guideline Adherence - statistics & numerical data Humans Life Sciences Middle Aged Multidisciplinary team meetings Patient Care Team - standards Quality Indicators, Health Care Retrospective Studies France Multidisciplinary team meetings Cancer care pathway EUSOMA quality indicators Early breast cancer
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Summary:	We evaluate breast cancer (BC) pathway at a regional level including public, private and university institutions. We assessed the quality of multidisciplinary team meetings (MTM) and compliance with a panel of European high-quality indicators (EUSOMA QIs). We conducted a retrospective multicenter (n = 20) study in the largest health care region in France. Between January and April 2015, we included all patients discussed at an MTM after a diagnosis of BC (n = 619). We analyzed quality of MTM by assessing the quorum, the reliability of data transcription and the exhaustivity of pre-therapeutic MTM. We then analyzed the compliance with a selected panel of 16 EUSOMA QIs. During MTM discussion, data were more than 95% consistent with medical records for 9/11 items. Pre-operative tumor histology (90.6%) and post-operative resection margins (84.3%) were the least concordant between medical records and MTM. Minimum standards as defined by EUSOMA were reached for 11/16 QIs, but not reached for pathology reports in non-invasive BC (78.2%), proportion of exclusive sentinel lymph node biopsies in patients with clinically negative axilla (85.2%), performing adjuvant chemotherapy (76.6%), and proportion of patients discussed in pre-therapeutic and post-operative MTM (63.5%). In this multicentric study evaluating the quality of BC care with a representative sample of institutions, compliance with EUSOMA indicators was satisfactory for all type of institutions. However, too few patients were discussed in pre-therapeutic MTM (especially in non-university hospitals 43.7% [39.4–48.1]) versus 88.7% for others [82.2–95.1]) and data transcription was likely responsible for up to 15% of discordance. •Real-life breast cancer care access includes private, public and universitary institutions.•Compliance with EUSOMA Quality indicators was satisfactory in real-life conditions.•Improvements need to be made regarding discussion in pre-therapeutic MTMs.•Reliability of the data transcription for pathology reports exceeded 95%.•Up to 15% of pathology data regarding post-operative resection margins were missing.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Undefined-2
ISSN:	0960-9776 1532-3080
DOI:	10.1016/j.breast.2019.06.001