Abstract P3-14-05: Accurately monitoring by specialist teams reduces the time between breast cancer screening and initial surgical treatment
Authors: Neff K , Kaufman CS 
Published: May 2019

Abstract
Background
Over 266,000 women are newly diagnosed with breast cancer every year in the United States, roughly 21% of women die of the disease annually.[1] Many studies have been conducted to evaluate how delays in diagnosis and treatment can result in adverse patient outcomes. Factors including tumor size and stage, socioeconomic status, race/ethnicity, and hospital size and capabilities have been shown to influence outcomes.
Variation in care delivery and turnaround times can be reduced by accurately examining the patient care path from initial screening mammography to first surgical intervention. We have developed a process to optimize timeliness to initial surgical treatment.
Methods
The process starts with observing care delivery from diagnostic mammogram, biopsy, pathology tissue processing, diagnosis and lumpectomy or mastectomy.
A team of process and clinical experts (Leica Biosystems) conducted observations to map out current care delivery processes. Standard national metrics for timeliness within the breast care pathway from the National Consortium of Breast Centers' was applied to the process map to understand national averages as well as best practices. Timeliness data on 5,571 patients from over 250 breast centers across the country from the NQMBC (National Quality Measures for Breast Centers) database was utilized to review time intervals and intradepartmental hand offs that impact progression through the breast care pathway.
Six sigma, black belt specialists conduct analysis of current breast center processes, identifies specific sites for improvement, integrates their recommendations and completes the cycle by repeat monitoring of the entire process.
Results
Our specialists have reviewed average and ideal overall performance in timeliness to initial surgical treatment. Improvements may be expected from 22%-75% in timeliness to initial surgical treatment.
Turnaround Time (Days) Mean*Best Practice**Time from screening to dx mammo6.04.9Time from dx mamo to bx5.94.1Time from bx to path report2.11.2Time from bx to first surgery22.616.9Total time from screening mammogram to first surgery36.627.1* Mean=average number of business days based on NQMBC data July-Dec. 2017** "Best Practice"=The 75th percentile based on data in NQMBC database July-Dec. 2017
Conclusion
A process to impact the timeliness of care between screening mammography and initial surgical treatment has been developed. Standardized and monitored care delivery processes can result in better efficiency in breast cancer patient care delivery from between 22% - 75%. Using a detailed patient care pathway and black belt specialists to analyze processes, we expect to reduce turnaround times and optimize efficiency across the breast cancer patient's care pathway.
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[1] Cancer Facts and Figures 2018; American Cancer Society
Citation Format: Neff K, Kaufman CS. Accurately monitoring by specialist teams reduces the time between breast cancer screening and initial surgical treatment [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-14-05.