TY - JOUR

T1 - The clinical database and implementation of treatment guidelines by the Danish Breast Cancer Cooperative Group in 2007–2016

AU - Jensen, Maj Britt

AU - Laenkholm, Anne Vibeke

AU - Offersen, Birgitte V.

AU - Christiansen, Peer

AU - Kroman, Niels

AU - Mouridsen, Henning T.

AU - Ejlertsen, Bent

PY - 2018

Y1 - 2018

N2 - Background: Since 40 years, Danish Breast Cancer Cooperative Group (DBCG) has provided comprehensive guidelines for diagnosis and treatment of breast cancer. This population-based analysis aimed to describe the plurality of modifications introduced over the past 10 years in the national Danish guidelines for the management of early breast cancer. By use of the clinical DBCG database we analyze the effectiveness of the implementation of guideline revisions in Denmark. Methods: From the DBCG guidelines we extracted modifications introduced in 2007–2016 and selected examples regarding surgery, radiotherapy (RT) and systemic treatment. We assessed introduction of modifications from release on the DBCG webpage to change in clinical practice using the DBCG clinical database. Results: Over a 10-year period data from 48,772 patients newly diagnosed with malignant breast tumors were entered into DBCG’s clinical database and 42,197 of these patients were diagnosed with an invasive carcinoma following breast conserving surgery (BCS) or mastectomy. More than twenty modifications were introduced in the guidelines. Implementations, based on prospectively collected data, varied widely; exemplified with around one quarter of the patients not treated according to a specific guideline within one year from the introduction, to an almost immediate full implantation. Conclusions: Modifications of the DBCG guidelines were generally well implemented, but the time to full implementation varied from less than one year up to around five years. Our data is registry based and does not allow a closer analysis of the causes for delay in implementation of guideline modifications.

AB - Background: Since 40 years, Danish Breast Cancer Cooperative Group (DBCG) has provided comprehensive guidelines for diagnosis and treatment of breast cancer. This population-based analysis aimed to describe the plurality of modifications introduced over the past 10 years in the national Danish guidelines for the management of early breast cancer. By use of the clinical DBCG database we analyze the effectiveness of the implementation of guideline revisions in Denmark. Methods: From the DBCG guidelines we extracted modifications introduced in 2007–2016 and selected examples regarding surgery, radiotherapy (RT) and systemic treatment. We assessed introduction of modifications from release on the DBCG webpage to change in clinical practice using the DBCG clinical database. Results: Over a 10-year period data from 48,772 patients newly diagnosed with malignant breast tumors were entered into DBCG’s clinical database and 42,197 of these patients were diagnosed with an invasive carcinoma following breast conserving surgery (BCS) or mastectomy. More than twenty modifications were introduced in the guidelines. Implementations, based on prospectively collected data, varied widely; exemplified with around one quarter of the patients not treated according to a specific guideline within one year from the introduction, to an almost immediate full implantation. Conclusions: Modifications of the DBCG guidelines were generally well implemented, but the time to full implementation varied from less than one year up to around five years. Our data is registry based and does not allow a closer analysis of the causes for delay in implementation of guideline modifications.

UR - http://www.scopus.com/inward/record.url?scp=85036640054&partnerID=8YFLogxK

U2 - 10.1080/0284186X.2017.1404638

DO - 10.1080/0284186X.2017.1404638

M3 - Journal article

C2 - 29202621

AN - SCOPUS:85036640054

VL - 57

SP - 13

EP - 18

JO - Acta Oncologica

JF - Acta Oncologica

SN - 1100-1704

IS - 1

ER -