Abstract 182P
Background
Quality indicators (QI) are a specific tool to measure the quality of provided care. QI must be reliable, relevant, interpretable, actionable, and measurable. Contrarily to invasive breast cancer (IBC), the management of in situ breast cancer (BCIS) with adjuvant endocrine treatment (ET) remains controversial. The study aims to investigate the use of adjuvant ET in breast cancer in European (EU) countries, employing the European Society of Breast Cancer Specialists (EUSOMA) database that contains data collected by EU breast centers, that in the relevant time period were part of the EUSOMA Network.
Methods
We identified all females with a new breast cancer diagnosed in the period 2010 to 2019 in the EUSOMA database. The analysis was conducted on anonymous and cumulative data. The data were registered by 58 EU breast centers, all of which entered at least 500 new diagnoses in the database in the ten-year period. Geographically, the contributing centers are located in Northern (Belgium, the Netherlands, Sweden), Central (Austria, France, Germany, Switzerland) and Southern (Italy, Portugal) EU. The use of ET by tumor behavior was studied in operated endocrine sensitive breast cancer. Trends were evaluated by age group (<50y, 50-69y, ≥70y) and geographical region (North, Central, South).
Results
A total of 77,835 operated patients with endocrine sensitive breast cancer was included, 72,749 IBC and 5,086 BCIS. In IBC, adjuvant ET was systematically given (94%) and in all age groups at least in 90%. Geographically, proportions were slightly higher in Southern EU breast centers (97%) compared to both Northern and Central EU (91%). In BCIS, 46% of endocrine sensitive patients received adjuvant ET. In patients older than 70 less adjuvant ET was used (38%) compared with the younger patients. Geographically, the same gradient as for IBC was observed: higher proportions in Southern EU breast centers (52%) compared to both Northern and Central EU (40%).
Conclusions
The study of the real-world use of adjuvant ET in BCIS revealed a remarkably high percentage. Geographical study between EU centers and regions demonstrated different practices. QI making use of real-world EU data can help to monitor, evaluate, and eventually guide and align good clinical practice in the management of BC.
Clinical trial identification
Editorial acknowledgement
EUSOMA Working Group: Bettina Ballardini,Centro di Senologia Gruppo MultiMedica, Ospedale San Giuseppe, Ospedale MultiMedica Castellanza, IRCCS MultiMedica, Italy. Elisabetta Benozzi,Centro di Riferimento Oncologico di Aviano, Italy. Johannes Berger, Elisabethinen Hospital Linz, Austria. Martine Berlière, Clinique du Sein Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium. Renzo Boldorini, AOU Maggiore della Carità e CPO -SSD Epidemiologia dei Tumori, Novara, Italy. Andrea Bonetti, Breast Centre Azienda Ulss9 Scaligera, Legnago, Italy. Marina Bortul, Breast Centre Azienda Sanitaria Universitaria Integrata di Trieste, Italy. Barbara Bussels, Radiotherapie, Gastro-intestinale oncologie en senologie, AZ Delta Roeselare, Belgium. Katia Cagossi, Breast Centre AUSL Modena Carpi, Italy. Maria João Cardoso, Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal. Birgit Carly, Breast Unit and Prevention Center Isala, Department Gynecology-Obstetrics, CHU St. Pierre, Brussels, Belgium. Francesco Caruso, Breast Centre Humanitas Catania, Humanitas Istituto Clinico Catanese S.p.A., Misterbianco, Catania, Italy. Carla Cedolini, Chirurgia Senologica, Dipartimento di Chirurgia Generale, Azienda Sanitaria Universitaria Integrata di Udine, Italy. Fabio Corsi, Breast Unit, Department of Surgery, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy and Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy. Elisabetta Cretella, Oncologia Medica, Ospedale di Bolzano, Azienda Sanitaria Alto Adige, Italy. Evelyn Despierre, Breast Clinic – Department of Gynaecology and Obstetrics, OLV-ziekenhuis, Aalst, Belgium. Luca Despini, Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy. Rudy Leon De Wilde, University Hospital für Gynecology, Pius Hospital, Carl von Ossietzky University, Oldenburg, Germany. Antonio Esgueva, Clinica Universidad de Navarra, Regional multicentre, Madrid, Spain. Gianluca Fogazzi, Medical Oncology, Istituto Clinico S.Anna – Brescia, Italy. Lucio Fortunato, Chirurgia Senologica,UOC Centro di Senologia, Azienda Ospedaliera San Giovanni Addolorata, Roma, Italy. José Luis Fougo, Breast Centre, Centro Hospitalar Universitário São João, Porto, Portugal. Kay Friedrichs, Mammazentrum Hamburg am Krankenhaus Jerusalem, Hamburg, Germany. Daniele Generali, Azienda Socio Sanitaria Territoriale di Cremona, Italy. Simona GrossiCentro Senologico Specialistico Asl Lanciano-Vasto-Chieti, Ortona, Italy. Alessandra Huscher, Centro Senologico Multidisciplinare Fondazione Poliambulanza, Brescia, Italy. Michalis Kailides, Nicosia Breast Centre, Nicosia, Cyprus. Christelle Levy, Institut Norman du Sein, Centre François Baclesse, Caen, France. Sophie Marquette, Jessa Ziekenhuis - Hasselt – Belgium. Francesco Meani, Centro di Senologia Svizzera Italiana, Ginecologia e Ostetricia OR Lugano, Switzerland. Lorenzo Menghini, Breast Centre Ospedale Infermi di Rimini, Italy. Stefania Montemezzi, Centro Hub di Senologia Azienda Ospedaliera Universitaria Integrata Verona, Italy. Antonino Musolino, Department of Medicine and Surgery, University of Parma, Italy and Medical Oncology and Breast Unit, University Hospital of Parma, Italy. Ida Negreiros, UDTI and Lisbon Breast Unit, CUF Oncology, CUF, S.A. Lisbon, Portugal. Roger Olofsson Bagge, Sahlgrenska Breast Center, Sahlgrenska University Hospital, Gothenburg, Sweden. Gianmatteo Pagani, Breast Centre, Istituto Europeo di Oncologia, Milano Italy. Ana Car Peterko, Department of General Surgery and Surgical Oncology, Clinical Hospital Centre Rijeka, Rijeka, Croatia. Annemie Prové, Medische Oncologie, GZA Ziekenhuizen, Oncologisch Centrum. Wilrijk, Belgium. Manuela Roncella, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. Gianni Saguatti, Breast Centre AUSL di Bologna -Azienda USL di Bologna - IRCCS Scienze Neurologiche, Bologna, Italy. Dimitri Sarlos, KSA Aarau Kantosspital, Aarau, Switzerland. Adele Sgarella, Breast Centre, Unità Operativa Complessa di Chirurgia Generale 3 Senologica e dei tessuti molli, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Gracienne Staelens, AZ Groeninge, Kortrijk, Belgium. Mario Taffurelli, IRCCS Azienda Ospedaliero-Universitaria di Bologna-Policlinico di Sant’Orsola, Bologna, Italy. Giovanni Tazzioli, Breast Unit Azienda Ospedaliero-Universitaria Policlinico Modena Italy. Corrado Tinterri, Humanitas Research Hospital Rozzano, Milan, Italy. Hans Torrenga, Deventer Ziekenhuis Hospital, Deventer, The Netherlands.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.