Abstract 5496: Breast cancer screening and treatment quality metrics across an entire racially diverse metropolitan area: Chicago
Authors: Murphy Anne Marie 
Published: August 2012

BACKGROUND: In Chicago, IL, Black women are 62% more likely to die from breast cancer (ca) than White women, a disparity exceeding the US breast ca mortality disparity (41%) and New York City (27%). Geographic variability in mortality rates suggests health system rather than biologic differences as a significant cause. The Metropolitan Chicago Breast Cancer Task Force's mission is to eliminate this disparity. In 2008, the Quality Consortium, a project of the Task Force, was established to address this issue through quality improvement and soon became the nation's first Patient Safety Organization dedicated solely to breast health. METHODS: We collected aggregate screening and/or treatment quality data for calendar year 2006 from 43 sites. Data from calendar year 2009 has recently been accepted from 53 sites and is an update on quality performance in Chicago. Environmental scans to review processes in breast care were conducted at 27 sites and results are being coupled with the new data to present a more complete picture of quality. The proportion of patients with screening, diagnostic follow up and treatment procedures aligned with clinical guidelines were used to determine whether institutions met benchmarks. 7 screening measures and their associated benchmarks included: proportions recalled for diagnosis (benchmark 5-14%), lost to follow-up at imaging (&lt;10%), lost to follow-up at biopsy (&lt;10%), follow-up imaging within 60 days of screening mammogram (≥90%), ca detection rate per 1000 screens (3-10), proportions diagnosed as minimal (&gt;30%), and diagnosed as stage 0 or 1 (&gt;50%). Three treatment measures and associated benchmarks included: proportions with treatment initiated within 60 days of diagnosis (≥80%), breast-conserving surgery (BCS) who received radiation (≥85%), and tested for hormone receptors (≥90%). RESULTS: Preliminary results show that varying percentages of institutions were able to show that they met benchmarks for recall rate (74%) lost to follow-up at imaging (36%) and at biopsy (42%), timely follow-up imaging (26%), ca detection rate (60%), proportion minimal (30%), proportion early stage (26%), timely treatment (75%), radiation after BCS (70%) and hormone receptor testing (90%). Environmental scans highlight areas of concern in positioning, patient communication, timeliness and provider handoffs. Complete and updated results will be available for presentation. CONCLUSIONS: There has been substantial improvement in data quality since the first cycle of data collection. Many mammography providers were unable to show they could meet benchmarks. Many treatment institutions demonstrated that they could meet standards of care. The results of the environmental scans and data together are being used to develop protocols and identify sites for quality improvement interventions. Conclusions will be revisited and presented once analysis is complete.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5496. doi:1538-7445.AM2012-5496