Abstract 1437
Background
A task force was created by the Belgian Society of Medical Oncology (BSMO) to monitor the quality of treatment of breast cancer in Belgium. In collaboration with the Belgian Cancer Registry an analysis of the data was performed in search of reliable quality indicators. Finding actionable differences can lead to better treatment of our patients.
Methods
Data of 48,872 patients diagnosed with invasive breast cancer between 2010 and 2014 were analysed. To enable risk stratification according to their surrogate subtype, pathology reports of year 2014 were manually checked (9,855 patients). We identified patients < 70 Y (years) and > 75 Y receiving adjuvant radiotherapy after mastectomy and the different systemic treatments in each surrogate subtype. We also calculated the total length of endocrine treatment and the percentage of chemotherapy given in first line ER+ metastatic patients.
Results
In cStage I-III, post-mastectomy radiotherapy was administered in 70.7% of the patients <70 Y and in 46.5% of patients > 75 Y, with an important intercenter variability. 81.7% of the cStage I-III patients <70 Y received at least 4.5 years of adjuvant endocrine therapy, with a slight decrease each year. In the 2014 cohort we identified 54.4% luminal A-like, 14.9% luminal B-like HER2-, 12.4% luminal B-like HER2+, 4.6% non luminal HER2+, 8.6% triple negative and 5.1% unknown. As a negative indicator, 44.6% of the HER2+ pT1aN0 patients <70 Y received adjuvant trastuzumab, compared to 22.2% of the patients > 70 Y. As first treatment for cStage IV HR+/HER2- patients, we identified endocrine therapy in 53.9% and chemotherapy in 17.3%.
Conclusions
Substantial treatment differences were observed among centers. Overtreatment is an important negative quality aspect of breast cancer management. A frequent use of postmastectomy radiotherapy was observed. The use of trastuzumab was inappropriate in pT1aN0 patients. Chemotherapy was used too often in first line hormone receptor positive metastatic patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Belgian Cancer Registry.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4581 - Timing to achieve complete response (CR) after definitive chemoradiotherapy (ChRT) in patients with squamous cell carcinoma of the anal (SCCAC) with and without HIV infection: a multicenter retrospective study
Presenter: Marcos Camandaroba
Session: Poster Display session 2
Resources:
Abstract
1712 - Planned organ preservation for T2 T3 M0 rectal adenocarcinoma. A possible option using chemoradiotherapy (CRT) and Contact X-ray Brachytherapy (CXB). A French multicenter study.
Presenter: Jean-Pierre Gérard
Session: Poster Display session 2
Resources:
Abstract
4639 - A Phase 1b Study of E7046 (AN0025) in Combination With Radiotherapy/Chemoradiotherapy (RT/CRT) in Preoperative Treatment of Rectal Cancer
Presenter: Lucjan Wyrwicz
Session: Poster Display session 2
Resources:
Abstract
2310 - Upfront radical surgery with total mesorectal excision (TME) versus preoperative chemoradiotherapy followed by TME in clinical stage II/III patients with rectal cancer: a propensity score analysis
Presenter: Ahrong Ham
Session: Poster Display session 2
Resources:
Abstract
2747 - Neoadjuvant chemoradiotherapy with/without lateral lymph node dissection for low rectal cancer: Which patients can benefit?
Presenter: Daisuke Nishizaki
Session: Poster Display session 2
Resources:
Abstract
2877 - The impact of completeness of chemotherapy on the efficacy of irinotecan in the preoperative chemoradiotherapy of locally advanced rectal cancer.
Presenter: Jingwen Wang
Session: Poster Display session 2
Resources:
Abstract
3050 - Feasibility of robot-assisted surgery in elderly patients with rectal cancer
Presenter: Wei-Chih Su
Session: Poster Display session 2
Resources:
Abstract
4109 - Feasibility of chemoradiotherapy in rectal cancer patients with peritumoral abscesses and fistulas: a case-control non-inferiority trial
Presenter: Valerii Ivanov
Session: Poster Display session 2
Resources:
Abstract
4813 - Differential of the nutritional index before and after neoadjuvant chemoradiotherapy as a prognostic factor of recurrence in patients with locally advanced adenocarcinoma of the rectum
Presenter: Leslie Navia-Ortuño
Session: Poster Display session 2
Resources:
Abstract
5345 - Short-term Clinical Outcomes of Robotic-Assisted Total Mesorectal Excision in Rectal Cancer after concurrent chemoradiotherapy
Presenter: Pojung Chen
Session: Poster Display session 2
Resources:
Abstract