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
5658 - Detection of 5-hydroxymethylcytosine in Circulating-Free DNA for Early Diagnosis of Colorectal Cancer
Presenter: Tianyu Liu
Session: Poster Display session 2
Resources:
Abstract
5779 - Detection of 5-hydroxymethylcytosine in Circulating-Free DNA for Prediction of The Efficacy of Conversion Therapy for Colorectal Cancer Liver Metastases
Presenter: Wenju Chang
Session: Poster Display session 2
Resources:
Abstract
4672 - mCRC gene profiling using the Idylla platform
Presenter: Christopher Bricogne
Session: Poster Display session 2
Resources:
Abstract
3393 - PIK3CA mutation in metastatic colorectal cancer (mCRC): association with clinico-pathological features and outcome
Presenter: Valentina Fanotto
Session: Poster Display session 2
Resources:
Abstract
1317 - Patient-Derived Xenografts (PDX) Identifies JMJD6 Inhibitor as an Effective Therapeutic Medicine in Colorectal Cancer.
Presenter: Feng Ye
Session: Poster Display session 2
Resources:
Abstract
1228 - DACH1 induced stemness of intestinal organoids by directly suppressing BMP signaling and contributes to intestinal tumorigenesis
Presenter: Xiang Hu
Session: Poster Display session 2
Resources:
Abstract
1147 - miR-148a inhibits early relapsed colorectal cancers and the secretion of VEGF by indirectly targeting HIF-1α under non-hypoxia/hypoxia conditions
Presenter: Hsiang-lin Tsai
Session: Poster Display session 2
Resources:
Abstract
1158 - Long noncoding RNA CASC21 promotes cell proliferation and metastasis in colon cancer.
Presenter: Qun Zhang
Session: Poster Display session 2
Resources:
Abstract
1259 - Prognostic and Predictive Impact On FMS-like Tyrosine Kinase 3 (FLT3) Amplification In Patients With Metastatic Colorectal Cancer
Presenter: Hiroko Hasegawa
Session: Poster Display session 2
Resources:
Abstract
1452 - RBP-Jκ in colon cancer cells facilitates tumor associated macrophages (TAMs)-induced cell metastasis by secreting CXCL11
Presenter: Meng jie Liu
Session: Poster Display session 2
Resources:
Abstract