Breast cancer care timeliness framework: A quality framework for cancer control
Document Type
Article
Publication Date
1-1-2022
Abstract
PURPOSE The aim of this study is to determine the pathway that women follow for Breast Cancer Care (BCC) and the time intervals from symptom discovery to treatment initiation and to develop a quality matrix framework. METHODS A retrospective cohort study was conducted at six tertiary centers in Malaysia. All women with newly diagnosed breast cancer were interviewed, and a medical records review was conducted using a structured questionnaire. The BCC timeliness framework showed that the total time between a woman discovering their first breast changes and the date of initial treatment was divided into three distinct intervals: presentation interval, diagnostic interval, and treatment interval. Four diagnosis subintervals, referral, biopsy, report, and diagnosis resolution intervals, were also looked into. RESULTS The BCC timeliness framework was used to capture important time points. The median total time, presentation interval, diagnostic interval, and treatment interval were 4.9 months (range, 1 month to 10 years), 2.4 months (range, 7 days to 10 years), 26 days (range, 4 days to 9.3 months), and 21 days (range, 1 day to 7.2 months), respectively. Meanwhile, the median time for the diagnosis subinterval of referral, biopsy, report, and diagnosis resolution was 8 days (range, 0 day to 8 months), 0 day (range, 0 day to 20 days), 7 days (range, 3 days to 3.5 months), and 4 days (range, 1 day to 1.8 months), respectively. CONCLUSION The BCC timeliness framework is based on the current sequenced trajectory of the BCC journey. Clarity in the measurement of timeliness provides a standardized language for monitoring and outcome research. It can serve as a quality indicator for community and hospital-based breast cancer programs. © 2022 by American Society of Clinical Oncology
Keywords
Breast, Breast Neoplasms, Female, Humans, Referral and Consultation, Retrospective Studies, Surveys and Questionnaires, Antineoplastic agent, Antineoplastic hormone agonists and antagonists, Adult, Aged, Article, Breast biopsy, Breast cancer, Cancer chemotherapy, Cancer control, Cancer diagnosis, Cancer hormone therapy, Cancer radiotherapy, Cancer surgery, Clinical audit, Clinical feature, Clinical pathway, Cohort analysis, Conceptual framework
Divisions
fac_med
Funders
Universiti Malaya, Kuala Lumpur, and High Impact Research (HIR) [Grant No: UM.TNC2/IPPP/UPGP/638/PPP],Ministry of Education, Malaysia [Grant No: UM.C/HIR/MOHE/06]
Publication Title
JCO Global Oncology
Volume
8
Publisher
Lippincott Williams and Wilkins