Héquet Delphine, Huchon Cyrille, Baffert Sandrine, Alran Séverine, Reyal Fabien, Nguyen Thuy, Combes Alix, Trichot Caroline, Alves Karine, Berseneff Hélène, Rouzier Roman
Department of Surgical Oncology, Institut Curie-Centre René Huguenin, 35 Rue Dailly, 92210 Saint-Cloud, France.
Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, 2 av de la source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
Br J Cancer. 2017 May 23;116(11):1394-1401. doi: 10.1038/bjc.2017.114. Epub 2017 Apr 25.
The European Society of Breast Cancer Specialists (EUSOMA) has defined quality indicators for breast cancer (BC). The aim of this study was to describe the preoperative clinical pathway of breast cancer patients and evaluate the determinants of compliance with EUSOMA quality indicators in the Optisoins01 cohort.
Optisoins01 is a prospective, multicentric study. Data from operable BC patients were collected, including results from before surgery to 1 year follow-up. Seven preoperative EUSOMA quality indicators were compared with the clinical pathways Optisoins01.
Six hundred and four patients were included. European Society of Breast Cancer Specialists targets were reached for indicator 1 (completeness of clinical and imaging diagnostic work-up), 3 (preoperative definitive diagnosis) and 5 (waiting time). For indicator 8 (multidisciplinary discussion), the minimum standard of 90% of the patients was reached only in general hospitals and comprehensive cancer centres. Having more than 1 medical examination within the centre was associated with an increased waiting time for surgery, whereas it was reduced by having an outpatient breast biopsy. The comprehensive cancer centre type was the only parameter associated with the other quality indicators.
European Society of Breast Cancer Specialists quality indicators are a useful tool to evaluate care organisations. This study highlights the need for a standardised and coordinated preoperative clinical pathway.
欧洲乳腺癌专家协会（EUSOMA）已明确了乳腺癌（BC）的质量指标。本研究旨在描述乳腺癌患者的术前临床路径，并评估Optisoins01队列中符合EUSOMA质量指标的决定因素。
Optisoins01是一项前瞻性、多中心研究。收集了可手术乳腺癌患者的数据，包括术前至术后1年随访的结果。将7项术前EUSOMA质量指标与Optisoins01的临床路径进行比较。
共纳入604例患者。在指标1（临床和影像诊断检查的完整性）、3（术前明确诊断）和5（等待时间）方面达到了欧洲乳腺癌专家协会的目标。对于指标8（多学科讨论），仅在综合医院和综合癌症中心达到了90%患者的最低标准。在中心内进行超过1次医学检查与手术等待时间延长相关，而门诊乳腺活检则可缩短等待时间。综合癌症中心类型是与其他质量指标相关的唯一参数。
欧洲乳腺癌专家协会质量指标是评估医疗组织的有用工具。本研究强调了标准化和协调术前临床路径的必要性。
