Objective: To evaluate the quality of operable breast cancer care in a tertiary care institution.
Design: A retrospective analysis of all breast cancer patients seen in our institution between 1995 and 2000. Data were abstracted from the charts of these patients. Indicators were based on an international consensus conference and other publications.
Setting: A tertiary care health care institution.
Main measures: We evaluated the charts and calculated the percentage for which the internationally accepted quality care indicators were followed during the continuum of care. We also reviewed the histopathological reports to evaluate conformation with the accepted indicators.
Results: Charts of 75 patients (four exclusions, three metastatic, and one male), diagnosed to have breast cancer during the study period were reviewed. Only 28 (37%) patients had triple assessment before a definitive surgical procedure. Pre-operative staging including a CT and bone scan was performed in 58 (77.3%). Among the 50 patients who had definite surgical intervention, the majority had mastectomy (44/50, 88%) whereas axillary dissection was performed in 46 (46/50, 92%). Estrogen and progesterone receptor status was reported in only four (4/50, 8%) and the exact tumor size in 24 (24/50, 48%) of the histopathological reports. Adjuvant chemotherapy was used in accordance with the international standards but radiotherapy was under-utilized.
Conclusion: Our study demonstrated that the quality of breast cancer care in this institution was below the accepted international standards. This study may be used to make interventions for improvement of quality in similar institutions all over the kingdom.