Breast cancer care: changing community standards.

A community hospital-based program was developed to improve breast cancer care in the community. A consensus was developed for what should be optimal care; a database was established to document the care being delivered in the community; and the data were analyzed to document changes in practice patterns over time. The major clinical benefits to patients included a significant improvement in needle biopsy rates, decreased utilization of second operative procedures, increased breast conservation surgery, conformity to guidelines for adjuvant chemotherapy administration, and a sizable increase in discovery of small breast cancers by screening mammography.