Several groups have developed clinical guidelines for the management of @entity0 , yet little data exist regarding their validation. Therefore, we examined the effect of published National @entity5 Network (NCCN) guidelines for invasive @entity0 on survival, quality of life (QOL), and hospital cost. From 260 consecutive @entity0 @entity1 , 129 @entity1 were identified for analysis: 93 @entity1 (72%) were treated according to the guidelines (NCCN+), while the treatment of 36 @entity1 (28%), with a similar stage distribution, deviated from the guidelines ( @entity25438 -). @entity1 were excluded from analysis with a diagnosis of @entity2735 , inflammatory @entity5 , @entity5 , and comorbid conditions that affected treatment. The 5-year survival was 87.6% for the NCCN+ @entity1 versus 83.3% for NCCN- @entity1 (P = 0.319 by Kaplan-Meier). Twelve QOL parameters were evaluated using a Likert-type scale (1 = severe and 5 = none). NCCN+ @entity1 had a cumulative QOL score of 4.18 +/- 0.08 versus 4.24 +/- 0.14 for NCCN- @entity1 (P = 0.745). Treatment-related costs were  20,300 +/- 1800 for NCCN+ @entity1 versus  59,700 +/- 25,200 for NCCN- @entity1 (P = 0.016 by t test). Although deviation from NCCN @entity0 guidelines had no effect on perceived quality of life or survival, there was a significant decrease in cost in the NCCN+ group. These findings suggest that adherence to NCCN guidelines can significantly reduce the cost of @entity0 care without adversely affecting either survival or quality of life.

Institutional validation of XXXX treatment guidelines.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity2735 :: ('MESH:D002278', 'Disease') :: ['carcinoma in situ'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'stage IV disease', 'Comprehensive Cancer'] @entity25438 :: ('CHEBI:29308', 'Chemical') :: ['NCCN']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
