Summary
The BCC timeliness framework is based on the current sequenced trajectory of the BCC journey. Clarity in the measurement of timeliness provides a standardized language for monitoring and outcome research. It can serve as a quality indicator for community and hospital-based breast cancer programs.
Original Article
Breast Cancer Care Timeliness Framework: A Quality Framework for Cancer Control
JCO Global Oncology
Noor Mastura Mohd Mujar, PhD; Maznah Dahlui, MD, PhD; Nor Aina Emran, MD; Imisairi Abdul Hadi, MD; Yang Wai Yan, MD; Sarojah Arulanantham, MD; Chan Hooi Chea, M3; and Nur Aishah Mohd Taib, MD, PhD
ABSTRACT
PURPOSE
The aim of this study is to determine the pathway that women follow for Breast Cancer Care (BCC) and the time intervals from symptom discovery to treatment initiation and to develop a quality matrix framework.
METHOD
A retrospective cohort study was conducted at six tertiary centers in Malaysia. All women with newly diagnosed breast cancer were interviewed, and a medical records review was conducted using a structured questionnaire. The BCC timeliness framework showed that the total time between a woman discovering their first breast changes and the date of initial treatment was divided into three distinct intervals: presentation interval, diagnostic interval, and treatment interval. Four diagnosis subintervals, referral, biopsy, report, and diagnosis resolution intervals, were also looked into.
RESULTS
The BCC timeliness framework was used to capture important time points. The median total time, presentation interval, diagnostic interval, and treatment interval were 4.9 months (range, 1 month to 10 years), 2.4 months (range, 7 days to 10 years), 26 days (range, 4 days to 9.3 months), and 21 days (range, 1 day to 7.2 months), respectively. Meanwhile, the median time for the diagnosis subinterval of referral, biopsy, report, and diagnosis resolution was 8 days (range, 0 day to 8 months), 0 day (range, 0 day to 20 days), 7 days (range, 3 days to 3.5 months), and 4 days (range, 1 day to 1.8 months), respectively.
CONCLUSION
The BCC timeliness framework is based on the current sequenced trajectory of the BCC journey. Clarity in the measurement of timeliness provides a standardized language for monitoring and outcome research. It can serve as a quality indicator for community and hospital-based breast cancer programs.
AUTHOR CONTRIBUTIONS
Conception and Design: Noor Mastura Mohd Mujar, Maznah Dahlui, Nur Aishah Mohd Taib
Financial support: Noor Mastura Mohd Mujar, Nor Aina Emran, Yang Wai Yan, Sarojah Arulanantham, Chan Hooi Chea, Nur Aishah Mohd Taib
Provision of study material or patients: All authors
Collection and assembly of data: All authors
Data analysis and interpretation: Noor Mastura Mohd Mujar, Maznah Dahlui, Nur Aishah Mohd Taib
Manuscript writing: All authors
Final approval of manuscript: All authors
Accountable for all aspects of the work: All authors