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Appropriateness and variation of surgical treatment of breast cancer in Italy: when excellence in clinical research does not match with generalized good quality care. Progetto Oncologia Femminile.

Scorpiglione, N, Nicolucci, A, Grilli, R, Angiolini, C, Belfiglio, M, Carinci, F, Cubasso, D, Filardo, G, Labbrozzi, D and Mainini, F (1995) Appropriateness and variation of surgical treatment of breast cancer in Italy: when excellence in clinical research does not match with generalized good quality care. Progetto Oncologia Femminile. J Clin Epidemiol, 48 (3). pp. 345-352.

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Abstract

To assess appropriateness of surgical care delivered to breast cancer patients in Italy and quantify the use of unnecessary radical procedures, a retrospective charts review of patients treated in 1988-1989 was conducted. A series of 1724 consecutive patients (median age 61 years; range 17-89) treated in 63 hospitals selected from within 8 regions with newly diagnosed operable breast carcinoma was evaluated. Overall, 541 (38%) patients had inappropriate surgery with more than two thirds of it being accounted for by the use of unnecessary mutilating Halsted mastectomy. Substantial geographic variation emerged in the overall rates of appropriateness (range 88-52%) which were not substantially affected by allowance for imbalances in patient- and hospital-related variables. Despite the important contribution given by Italian clinical researchers to the demonstration that less radical surgery can be as good as more radical procedures, still a substantial proportion of breast cancer patients are treated too aggressively. Besides pointing to the urgent need of interventions aimed at facilitating the process of technology transfer in order to promote more appropriate surgical care, these results suggest that efforts to increase patients' participation into treatment decision and awareness about alternative treatment options are warranted.

Item Type: Article
Authors :
NameEmailORCID
Scorpiglione, NUNSPECIFIEDUNSPECIFIED
Nicolucci, AUNSPECIFIEDUNSPECIFIED
Grilli, RUNSPECIFIEDUNSPECIFIED
Angiolini, CUNSPECIFIEDUNSPECIFIED
Belfiglio, MUNSPECIFIEDUNSPECIFIED
Carinci, Ff.carinci@surrey.ac.ukUNSPECIFIED
Cubasso, DUNSPECIFIEDUNSPECIFIED
Filardo, GUNSPECIFIEDUNSPECIFIED
Labbrozzi, DUNSPECIFIEDUNSPECIFIED
Mainini, FUNSPECIFIEDUNSPECIFIED
Date : March 1995
Uncontrolled Keywords : Adolescent, Adult, Aged, Breast Neoplasms, Confidence Intervals, Decision Making, Female, Humans, Italy, Mastectomy, Modified Radical, Mastectomy, Radical, Middle Aged, Odds Ratio, Patient Participation, Quality of Health Care, Regression Analysis, Research, Retrospective Studies, Technology Transfer, Utilization Review
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 17 May 2017 10:42
Last Modified : 17 May 2017 10:42
URI: http://epubs.surrey.ac.uk/id/eprint/828882

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