Quality Assurance Report TTUHSC Breast Center of Excellence January 1, 2014 – December 31, 2014 Compiled by L.Day, RN BSN CCM CCRP OCN 1.

Slides:

Advertisements

Similar presentations

Mammary ductal carcinoma

Advertisements

Baptist Health System General Surgery Residency Program

Pimp Session: Breast By James Lee, MD.

Advances and Emerging Therapy for Lung Cancer

Breast Cancer. Introduction Most common female cancer Accounts for 32% of all female cancer 211,300 new cases yearly and rising 40,000 deaths yearly.

Kevin S. Hughes, MD, FACS Co-Director, Avon Comprehensive Breast Evaluation Center Massachusetts General Hospital Associate Professor of Surgery Harvard.

Breast Cancer in Pregnancy

An update for Illinois Nurses Elizabeth A. Peralta, MD The Breast Center at SIU Springfield, IL May 2011.

Christine Simmons, MD MSc FRCPC Medical Oncologist, BCCA Vancouver

Breast Reconstruction: Outcomes Analysis Michael J Bass, MD, JD Michael J Bass Plastic Surgery, PLLC.

Abstract Neoadjuvant Chemotherapy First, Followed by Chemoradiation and Then Surgery, in the Management of Locally Advanced Rectal Cancer A. Cercek, K.

Sentinel Lymph Node Dissection (SND)

Breast cancer and medical second opinion

Breast Cancer 101 Barbara Lee Bass, MD, FACS Professor of Surgery

AJCC TNM Staging 7th Edition Breast Case #3

BIOLOGICAL PRINCIPLES OF BREAST CANCER TREAMENT Benjamin O. Anderson, M.D. Director, Breast Health Clinic Professor of Surgery and Global Health, University.

Radiotherapy in Carcinoma of the Breast Patrick S Swift, MD Director, Radiation Oncology Alta Bates Comprehensive Cancer Center Berkeley, CA.

Hot topics in breast radiotherapy Mark Beresford.

Ductal Carcinoma in situ

Neoadjuvant Chemotherapy for Ca Breast CY Choi UCH.

AJCC Staging Moments AJCC TNM Staging 7th Edition Breast Case #2 Contributors: Stephen B. Edge, MD Roswell Park Cancer Institute, Buffalo, New York David.

Elshami M.Elamin, MD Medical Oncologist Central Care Cancer Center Wichita, KS, USA

Maximally-Invasive Curriculum: A Model Curriculum for Osteopathic Surgical Residencies (ACOS) India Broyles, EdD University of New England College of Osteopathic.

Colorectal Cancer Center Jena Introduction In Germany, there are currently approximately newly diagnosed patients with colorectal carcinoma.

Breast conservation in Locally advanced breast cancer Department of Endocrine Surgery College of Medicine Amrita Institute of Medical Sciences Kochi, Kerala.

Nurse Navigators and the Cancer Institute Yousuf A. Gaffar, MD Hematology / Medical Oncology The Cancer Institute University of Maryland St. Joseph Medical.

Breast Cancer Clinical Cases Daniel A. Nikcevich, MD, PhD SMDC Cancer Center April 20, 2009.

Ductal Carcinoma In Situ (DCIS)

Suggested guidelines for appropriate patient selection for patients undergoing Accelerated Partial Breast Irradiation at DMC. Tonya Echols Cole, MD.

AJCC Staging Moments AJCC TNM Staging 7th Edition Breast Case #1 Contributors: Stephen B. Edge, MD Roswell Park Cancer Institute, Buffalo, New York David.

 Determining the Nature of a Breast Abnormality  It is a procedure that may be used to determine whether a lump is a cyst (sac containing fluid) or a.

Breast Cancer Methods for Early Detection. Breast Cancer What It Is Methods of Early Detection Risk Factors.

NYU Medical Grand Rounds Clinical Vignette Daniel P. Eiras, MD, MPH PGY2 December 1, 2010 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.

Breast Cancer: The Profile Ma. Belen E. Tamayo,M.D. Medical Oncologist Makati Medical Center The Medical City.

Quality Assurance Report TTUHSC Breast Center of Excellence January 1, 2013 – December 31, 2013 Compiled by Uzma Nazim, M.D.

2014 Cancer Program Performance Outcomes. Introduction Saint Agnes Medical Center has proudly maintained a American College of Surgeons’ Commission on.

Genomic Health, Inc. Yuko Soneoka, Ph.D., J.D. Senior Corporate Counsel, IP Director of Intellectual Property January 31, 2013.

The Colorectal Cancer Center Jena Gharbi A, Settmacher U. Department of General, Visceral and Vascular Surgery, Friedrich-Schiller-University Jena

Radical Mastectomy is no longer the standard Improved adjuvant and neoadjuvant therapy Chemotherapy Endocrine therapy Radiation treatment Reconstruction.

MBCG Project Primary Results MEDICALSURVEYS-17 RESEARCH GROUP IN COLLABORATION WITH THE EASO.

Recent and evolving trends in breast and colon cancer by Jeff Kolbasnik.

Quality Assurance Report TTUHSC Breast Center of Excellence January 1, 2009 – December 31, 2009.

Quality Assurance Report TTUHSC Breast Center of Excellence January 1, 2011 – December 31, 2011 Compiled by Lynn Day, RN BSN CCM CCRP.

2015 Cancer Program Performance Outcomes. Introduction Saint Agnes Medical Center has proudly maintained a American College of Surgeons’ Commission on.

Radiotherapy Protocols Bristol protocol version 12.

Quality Assurance Report TTUHSC Breast Center of Excellence January 1, 2012 – December 31, 2012 Compiled by Uzma Nazim, M.D.

SLNB The RUH experience A 2014 Audit Dr M Stoddart, Dr S Cole, Mr J Horsnell and Mr R Sutton Royal United Hospital, Bath.

Quality Assurance Report TTUHSC Breast Center of Excellence January 1, 2010 – December 31, 2010 Compiled by Lynn Day, RN BSN CCM CCRP.

Extranodal Extension on Sentinel Lymph Node Dissection: Why Should We Treat It Differently? Audrey Choi MD, Matthew Surrusco MD, Samuel Rodriguez MD, Khaled.

Basis and Outcome of Axillary Dissection for Node Negative Axilla Gurpreet Singh Dept. Of Surgery P.G.I.M.E.R. These Power Point presentations are free.

SLNB Scenario Group Discussion Presented at: The Sentinel Lymph Node Biopsy Surgery Refresher Course October 29, 2010.

Annals of Oncology 24: 2206–2223, 2013 R3 조영학

Quality & Sustainability in Cancer Control: A System Performance Spotlight Report To use a hyperlink, right click on it and select ‘Open Hyperlink’, or.

Presented at the NAACCR Annual Conference Quebec City June 22, 2010.

PHASE II TRIAL OF HYPOFRACTIONATED BREAST IRRADIATION WITH VMAT-SIB TECHNIQUE: TOXICITY AND EARLY CLINICAL ASSESSMENT IN 270 PATIENTS F. De Rose¹, F. Alongi¹,

MULTI-DISCIPLINARY CANCER MANAGEMENT John B. Hamner, MD, FACS Assistant Professor Surgical Oncology Tulane University.

Breast Cancer Treatment. Treatment 2 aspects 1. Treatment of the breast itself: “Local Treatment” 2. Treatment of the whole body = “Systemic treatment”

Overview: Breast Cancer- Surgical Treatment

Nicolas Ajkay, MD, FACS Assistant Professor of Surgery

Indications for Breast MR Imaging

Dr Amit Gupta Associate Professor Dept Of Surgery

Surgical Management of the Breast in Breast Cancer

THBT neoadjuvant endocrine therapy is to be used in post-menopausal breast cancer woman Antonino Grassadonia Università «G. D’Annunzio» – Chieti-Pescara.

Marcelo Calil Instituto Brasileiro de Controle do Câncer

徐慧萍1 羅竹君1,2 郭耀隆1 李國鼎1 國立成功大學醫學院附設醫院外科部1 國立成功大學醫學院臨床醫學研究所2

Treatment Overview: The Multidisciplinary Team

Early and locally advanced breast cancer

Dr. Damjanovich László Dr. Fülöp Balázs

Presentation transcript:

Quality Assurance Report TTUHSC Breast Center of Excellence January 1, 2014 – December 31, 2014 Compiled by L.Day, RN BSN CCM CCRP OCN 1

Stage Distribution Total Number of Patients =55 Time Frame Stage 0Stage IStage IIStage IIIStage IVStage Unassigned Total Jan – Jun 5/27 (18.52%) 13/27 (48.15%) *8/27 (29.63%) 0/27 (0%) 1/27 (33.3%) 0/27 (3.7%) 27/27 (100%) Jul - Dec 7/28 (25%) 8/28 (28.57%) 11/28 (39.29%) 1/28 (3.57%) *1/28 (3.57%) 0/28 (0%) 28/28 (100%) Jan-Dec 12/55 (21.8%) 21/55 (38.2%) *19/55 (34.55%) 1/55 (1.82%) *2/55 (3.64%) 0/55 (0%) 55/55 (100%) Compiled by L. Day, RN BSN CCM CCRP OCN 2 * One patient added based on clinical staging

Time FrameStage 0Stage IStage IIStage IIIStage IVStage Unassigned Total Jan – Jun Preoperative Core 5/5 (100%) 13/13 (100%) *8/8 (100%) 0/0 (0%) 1/1 (100%) 0/0 (0%) 27/27 (100%) Jul – Dec Preoperative Core 7/7 (100%) 8/8 (100%) 11/11 (100%) 1/1 (100%) *1/1 (100%) 0/0 (0%) 28/28 (100%) Jan-Dec Preoperative Core 12/55 (21.82%) 21/55 (38.2%) *19/55 (34.55%) 1/55 (1.82%) *2/55 (3.64%) 0/0 (0%) 55/55 (100%) Compiled by L. Day, RN BSN CCM CCRP OCN 3 Mode of Diagnosis Total Number of Patients =55 100% of patients had diagnosis established on preoperative core needle biopsy *1 patient added from clinical stage who did not have surgery.

Tumor Board Discussion Total Number of Patients =55 Time Frame Stage 0Stage IStage IIStage IIIStage IVStage Unassigned Total Jan – Jun Discussed 4/5 (80%) 13/13 (100%) 7/7 (100%) 0/0 (0%) 1/1 (100%) *1/1 (100%) 26/27 (96.3%) Jul – Dec Discussed 7/7 (100%) 8/8 (100%) 11/11 (100%) 1/1 (100%) 0/0 (0%) *1/1 (100%) 28/28 (100%) Jan-Dec Discussed 11/12 (91.67% ) 21/21 (100%) 18/18 (100%) 1/1 (100%) 1/1 (100%) *2/2 (100%) 54/55 (98.2%) Compiled by L.Day, RN BSN CCM CCRP OCN % of patients were discussed in the multidisciplinary tumor conference * clinical staging-patient did not have surgery.

Time Frame Stage 0Stage IStage IIStage IIIStage IVStage Unassigned Total Jan – Jun MDC seen 4/5 (80%) 11/13 (84.62%) 6/7 (85.7%) 0/0 (0%) 1/1 (100%) *0/1 (0%) 22/27 (81.48%) Jul – Dec MDC seen 7/7 (100%) 8/8 (100 %) 10/11 (90.9%) 1/1 (100%) 0/0 (0%) *1/1 (100%) 27/28 (96.43%) Jan-Dec MDC seen 11/12 (91.67%) 19/21 (90.48%) 16/18 (88.89%) 1/1 (100%) 1/1 (100%) *1/2 (50%) 49/55 (89.1%) Compiled by L.Day, RN BSN CCM CCRP OCN 5 Multidisciplinary Assessment (Surgical, Medical and Radiation Oncologist) Total Number of Patients = 55 Multidisciplinary Assessment (Surgical, Medical and Radiation Oncologist) Total Number of Patients = 55 Exceptions: 6/55 Mastectomy 2/6 Patients with DCIS 1/6 Patient choice 1/6 Patient transferred 1/6 Patient with comorbidities 1/6 *clinical staging-patient did not have surgery

Time FrameStage 0Stage IStage IIStage IIIStage IVStage Unassigned Total Jan – Jun Assigned 5/5 (100%) 12/13 (92.31%) 7/7 (100%) 0/0 (0%) 1/1 (100%) *1/1 (100%) 26/27 (96.3%) Jul – Dec Assigned 7/7 (100%) 8/8 (100%) 11/11 (100%) 1/1 (100%) 0/0 (0%) *1/1 (100%) 28/28 (100%) Jan-Dec Assigned 12/12 (100%) 20/21 (95.24%) 18/18 (100%) 1/1 (100%) 1/1 (100%) *2/2 (100%) 54/55 (98.2%) Compiled by L. Day, RN BSN CCM CCRP OCN 6 Nurse Navigation Total Number of Patients = 55 Exceptions 1/55 (1.82%) Patient sought second opinion out of area/second primary cancer *clinical staging-patient did not have surgery

Time FrameStage 0Stage IStage IIStage IIIStage IVStage Unassigned Total Jan – Jun Yes 0/5 (0%) 13/13 (100%) 7/7 (100%) 0/0 (0%) 1/1 (100%) *0/1 (0%) 21/27 (77.78%) Jul – Dec Yes 0/7 (0%) 8/8 (100%) 11/11 (100%) 1/1 (100%) 0/0 (0%) *0/1 (0%) 20/28 (71.43%) Jan-Dec Yes 0/12 (0%) 21/21 (100%) 18/18 (100%) 1/1 (100%) 1/1 (100%) *0/2 (0%) 41/55 (74.55%) Compiled by L.Day, RN BSN CCM CCRP OCN 7 CAP Compliance Total Number of Patients = 55 Exceptions14/55(25.5%) Margins can not be assessed 4/14 Patient transferred 1/14 Patient deceased during treatment 1/14 DCIS 8/14 *clinical staging-patient did not have surgery

Axillary Staging Total Number of Patients = 55 Total Number of Patients with Invasive Cancer = 47 Number node positive patients on needle biopsy 3/47 (6.38%) Number of pts. with Stage IV disease 1/47 (2.13%) Number of patients eligible for SLNB40/40 (100%) Number of patients with SLNB33/40 (82.5%) Exceptions 7/40 (17.5%) Pathological stage 0 post-neoadjuvant 4/7 (57.14%) SLN during mastectomy for DCIS to avoid missed opportunity 1/7 (14.28%) Patient transferred 1/7 (14.28%) Patient deceased during treatment 1/7 (14.28%) Compiled by L. Day, RN BSN CCM CCRP OCN 8

Axillary Dissection Total Number of Patients = 55 Total Number of Patients with Invasive Cancer = 43 Axillary Dissection Total Number of Patients = 55 Total Number of Patients with Invasive Cancer = 43 Number of patients with stage IV1/43 (2.33%) Number of patients with node positive disease 17/43 (39.53%) Number of patients eligible for ALND 17 Number of patients with ALND9/17 (52.94%) Exceptions10/17 (58.82%) Patient opted for radiation/hormonal treatment instead of ALND 7/10 (70%) Patient comorbidities1/10 (10%) Pathological stage 0 after neo-adjuvant, negative SLNB2/10 (20%) Compiled by L. Day, RN BSN CCM CCRP OCN 9

Time Frame Stage 0Stage IStage IIStage IIIStage IVStage Unassigned Total Jan – Jun Yes 2/5 (40%) 11/13 (84.62%) 4/7 (57.14%) 0/0 (0%) 0/1 (0%) 0/1 (0%) 17/27 (62.96%) Jul – Dec Yes 6/7 (85.71%) 7/8 (85.7%) 5/11 (45.5%) 1/1 (100%) 0/0 (0%) 0/1 (0%) 19/28 (67.86%) Jan-Dec Yes 8/12 (66.67%) 18/21 (85.7%) 9/18 (50%) 1/1 (100%) 0/1 (0%) 0/2 (0%) 36/55 (65.5%) Compiled by L. Day, RN BSN CCM CCRP OCN 10 Breast Conservation Total Number of Patients = 55 Number of early stage pts. (0, I and II) with breast conservation 35/51 (68.6%) Mastectomies done 17/55 (30.9%) Exceptions 2/55 Transferred Care 1/2 Deceased during treatment 1/2

Post-lumpectomy Radiation Total Number of Patients =55 Number of patients with lumpectomy 36/55 (65.5%) Number of patients eligible for Radiation 36 Number of patients radiated 32/36 (88.9%) Number of patients radiated within 12 months 31/32 (96.9%) Exceptions 4/36 (11.1%) Patient with comorbidities 1/4 (25%) Patient refused to get radiation 2/4 (50%) Low risk malignancy 1/4 (25%) Compiled by L. Day, RN BSN CCM CCRP OCN 11

Post-Mastectomy Radiation Total Number of Patients = 55 Number of patients with mastectomy 17/55 (24.3%) Number eligible for radiation (>T3 or >N2) 2/17 (27.7%) Number of patients radiated 2/2 (40%) Number of patients radiated within 12 months 2/2 (100%) Exceptions NONE Compiled by L. Day, RN BSN CCM CCRP OCN 12

Systemic Chemotherapy – ER Neg. Total Number of Patients = 55 ER negative patients with cancer8/55 (14.5%) Number eligible for chemotherapy8/8 (100%) Number treated with chemotherapy8/8 (100%) Number with chemotherapy within 4 months 8/8 (100%) Exceptions NONE ER negative post neo-adjuvant stage 0 2/8 (25%) Compiled by L. Day, RN BSN CCM CCRP OCN 13

Systemic Chemotherapy – ER Pos. Total Number of Patients = 55 ER positive patients with cancer47/55 (85.5%) Number treated with chemotherapy18/47(38.3%) Number with chemotherapy within 4 months17/18 (94.4%) Exceptions 1/1 (100%) Treatment delay due to competing comorbidity 1/1 (100%) Compiled by L. Day, RN BSN CCM CCRP OCN 14

Systemic Endocrine Therapy Total Number of Patients = 55 Number of ER positive patients 47/55 (85.5%) Number treated with endocrine therapy 42/47 (89.4%) Exceptions 5/47 (10.64%) Determined risk > benefit 2/5 (40%) Patient non compliant 2/5 (40%) Patient transferred 1/5 (20%) Number with endocrine therapy within 1 year 41/47 (87.2%) Compiled by L. Day, RN BSN CCM CCRP OCN 15

Rehabilitation Total Number of Patients =55 Rehabilitation Total Number of Patients =55 Number enrolled in CPRP (PT/OT)22/55 (40%) Exceptions33/55 (60%) Services were available but structured program is pending definitive establishment, whereby every patient gets a baseline arm girth and shoulder range of motion documented; prospective data is maintained with a pre-designed schedule. Pts. enrolled in CPRP in /107 (22.43%) Pts. enrolled in CPRP in /74 (49%) Pts. enrolled in CPRP in /74 (59.5%) Pts. enrolled in CPRP in /55 (40%) Enrollment decline over % Compiled by L. Day, RN BSN CCM CCRP OCN 16

Genetic Counseling Total Number of Patients = 55 Genetic Counseling Total Number of Patients = 55 Number of patients with family history or < 45 years39/55 (70.9%) Number received genetic counseling18/39 (46.2%) Number tested16/18 (88.9%) Positive 0/0 (0%) Negative16/16 (100%) Number refused testing 2/18 (11.1%) Exceptions-did not meet NCCN guidelines 21/39 (53.8%) Compiled by L. Day, RN BSN CCM CCRP OCN 17

Reconstruction For Mastectomy Total Number of Patients = 55 Reconstruction For Mastectomy Total Number of Patients = 55 Number of patients with mastectomy17/55 (30.91%) Number of patients with reconstruction13/17 (76.5%) Exceptions 6/19 (31.6%) Pts. Offered but refused 3/6 (50%) Stage IV patient with palliative mastectomy 1/6 (16.67%) No surgery-deceased or transferred care 2/6 (33.3%) Number of patients with reconstruction in /19 (63.2%) Number of patients with reconstruction in /17 (76.5%) Improvement over % Compiled by L. Day, RN BSN CCM CCRP OCN 18

Compiled by L.Day, RN BSN CCM CCRP OCN 19 Time Frame Trial / StudyEligible N (%) Participation N (%) Jan – Jun B-SMART44 (100%) NBRST00 (0%) SPOC44 (100%) MULTIPLE STUDIES1711 (100%) Total 25/27 (92.6%)19/25 (76%) Jul - Dec B-SMART44 (100%) NBRST22 (100%) SPOC11 (100%) MULTIPLE STUDIES1712 (81.2%) Total 24/28 (85.7%) 19/24 (79.2%) GRAND TOTAL49/55 (89.1%)38/49 (77.6%) Trial Participation Total Number of Patients = 55 Patients participated in trials for /55 (69.1%)