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Breast cancer practice guidelines: evaluation and quality improvement

S B Edge1

  • 1Division of Surgical Oncology, Roswell Park Cancer Institute, State University of New York, Buffalo, USA.

Oncology (Williston Park, N.Y.)
|January 16, 1998
PubMed
Summary

Practice guidelines for breast cancer management are not yet proven useful. Their effective implementation requires integration into quality improvement programs with mechanisms for ongoing revision and evaluation.

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Area of Science:

  • Oncology
  • Health Services Research
  • Clinical Practice Guidelines

Background:

  • The effectiveness of practice guidelines in breast cancer management requires further investigation.
  • Existing guidelines offer a foundation for evaluating the quality of breast cancer care.
  • Several comprehensive guideline programs exist, including those from the National Comprehensive Cancer Network (NCCN).

Purpose of the Study:

  • To examine the scope and goals of published breast cancer practice guidelines.
  • To assess the utility of these guidelines in improving the quality of breast cancer treatment.
  • To explore the necessary components for effective guideline implementation and evaluation.

Main Methods:

  • Review of published breast cancer practice guidelines.

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  • Analysis of guideline scope, intent, and potential for quality improvement.
  • Identification of key elements for guideline utilization and evaluation.

    • Main Results:

    • Breast cancer guidelines vary in scope and intent but provide a framework for quality assessment.
    • Comprehensive guideline programs exist, such as those from ACCC, SSO, and NCCN.
    • Guidelines are useful only when part of a broader quality improvement initiative.

    Conclusions:

    • Practice guidelines are valuable tools for breast cancer quality improvement when integrated into comprehensive programs.
    • Effective guidelines require mechanisms for revision and evaluation.
    • Assessing guideline utility in breast cancer care is a complex, long-term process involving multiple stakeholders.