Effects of guideline adherence in primary breast cancer–A 5-year multi-center cohort study of 3976 patients

Wöckel, Achim; Kurzeder, Christian; Geyer, Verena; Novasphenny, Igor; Wolters, Regine; Wischnewsky, Manfred; Kreienberg, Rolf; Varga, Dominic

doi:10.1016/j.breast.2009.12.006

« Previous Next »The Breast
Volume 19, Issue 2 , Pages 120-127, April 2010

Effects of guideline adherence in primary breast cancer–A 5-year multi-center cohort study of 3976 patients

Achim Wöckel
- Department of Gynecology and Obstetrics, University Hospital Ulm, University of Ulm Medical Center, Prittwitzstrasse 43, 89075 Ulm, Germany
- Corresponding author. Tel.: +49 (0) 731 500 585 01; fax: +49 (0) 731 500 585 02.
Christian Kurzeder
- Department of Gynecology and Obstetrics, University Hospital Ulm, University of Ulm Medical Center, Prittwitzstrasse 43, 89075 Ulm, Germany
Verena Geyer
- Department of Gynecology and Obstetrics, University Hospital Ulm, University of Ulm Medical Center, Prittwitzstrasse 43, 89075 Ulm, Germany
Igor Novasphenny
- Department of Mathematics and Computer Science, University of Bremen, Germany
Regine Wolters
- Department of Mathematics and Computer Science, University of Bremen, Germany
Manfred Wischnewsky
- Department of Mathematics and Computer Science, University of Bremen, Germany
Rolf Kreienberg
- Department of Gynecology and Obstetrics, University Hospital Ulm, University of Ulm Medical Center, Prittwitzstrasse 43, 89075 Ulm, Germany
Dominic Varga
- Department of Gynecology and Obstetrics, University Hospital Ulm, University of Ulm Medical Center, Prittwitzstrasse 43, 89075 Ulm, Germany

Received 26 July 2009; received in revised form 12 December 2009; accepted 14 December 2009. published online 01 February 2010.

Abstract

Background

The aim of that study was to analyze the impact of German-S3-breast cancer guideline adherence on clinical outcomes.

Methods

A retrospective study analyzed 3976 patients first diagnosed with primary breast cancer according to an S3-guideline-based model that classified patients retrospectively into groups receiving “guideline-adherent and “guideline non-adherent” therapy.

Results

There was a significant association between treatment adherence and prolonged recurrence free and overall survival (p = 0.0001). The greater the number of violations in guideline adherence, the lower was overall survival (p = 0.0001). Advanced age at initial diagnosis was additionally associated with a reduction in guideline adherence. The percentage of guideline adherence for the therapeutic modalities BCT, mastectomy, axillary dissection and hormone therapy was greater than 80%. For chemotherapy, the percent of guideline adherence totaled 71.4%.