van Maaren Marissa C, Voorham Quirinus J M, Wijnen Eveline M, de Munck Linda, Wesseling Jelle, Visser Otto, Siesling Sabine
Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), P.O. Box 19079, Utrecht 3501 DB, the Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, Enschede 7500 AE, the Netherlands.
Palga foundation, de Bouw 123, Houten 3991 SZ, the Netherlands.
Cancer Epidemiol. 2025 Jun;96:102780. doi: 10.1016/j.canep.2025.102780. Epub 2025 Mar 6.
Usually, data on locoregional recurrent breast cancer (LRR) are collected by reviewing all patient files of a specific cohort, despite only few patients actually have a LRR. We describe and validate a new procedure in which notifications of LRRs are obtained via pathology reports, which could improve efficiency.
Patients diagnosed with nonmetastatic invasive breast cancer between 2012 and 2016 were identified from the Netherlands Cancer Registry (NCR) and linked to the Dutch Nationwide Pathology Databank (Palga). LRRs were identified using a complex algorithm based on codes and text in pathology reports, whereafter only files from patients with a notification - i.e. patients who were suspected of having had a LRR - were consulted for confirmation and additional information. To validate this procedure, patients diagnosed between January-March 2012 - of whom data on LRRs were previously collected manually by registrars from the Netherlands Cancer Registry - were used as the gold standard. Subsequently, patients with LRRs not notified by the new method were identified and original pathology reports and clinical reports were evaluated to find reasons for the lack of notification.
In total, 88,257 patients were linked to Palga, and 5069 patients were labelled with a notification. In patients diagnosed between January-March 2012 (validation cohort, n = 3092), 270 patients were labelled with a notification. Of these patients, 82 (2.7 %) were diagnosed with a LRR. The notification method identified 63 patients (77 %) with LRRs. Missed notifications were due to clinical diagnoses (not available in Palga, 53 %) or incomplete/incorrect pathological reporting (47 %). The notification method resulted in cost savings of €2.949.127,- as compared to the manual scenario.
Using the notification method, almost 80 % of the patients with LRRs were identified, with huge reductions in registration burden and costs. The incompleteness should be considered in future analyses. Improvement in pathology reporting could increase completeness.
通常，局部区域复发性乳腺癌（LRR）的数据是通过查阅特定队列的所有患者档案收集的，尽管实际上只有少数患者发生LRR。我们描述并验证了一种新程序，即通过病理报告获取LRR通知，这可能会提高效率。
从荷兰癌症登记处（NCR）识别出2012年至2016年间被诊断为非转移性浸润性乳腺癌的患者，并将其与荷兰全国病理数据库（Palga）相链接。使用基于病理报告中的编码和文本的复杂算法识别LRR，之后仅查阅有通知的患者（即疑似发生LRR的患者）的档案以进行确认和获取更多信息。为验证此程序，将2012年1月至3月期间诊断的患者（荷兰癌症登记处的登记员此前已手动收集其LRR数据）用作金标准。随后，识别出未通过新方法通知的LRR患者，并评估原始病理报告和临床报告以找出未通知的原因。
总共88257名患者与Palga相链接，5069名患者被标记有通知。在2012年1月至3月期间诊断的患者（验证队列，n = 3092）中，270名患者被标记有通知。在这些患者中，82名（2.7%）被诊断为LRR。通知方法识别出63名（77%）LRR患者。未通知的原因是临床诊断（Palga中没有，53%）或病理报告不完整/不正确（47%）。与手动操作相比，通知方法节省了2949127欧元的成本。
使用通知方法，识别出了近80%的LRR患者，登记负担和成本大幅降低。在未来分析中应考虑不完整性。病理报告的改进可提高完整性。
