Evidence map›Paper›PMID 31260396›Full record

ArticleJournal of global oncology2019

Breast Cancer Care in South India: Is Practice Concordant With National Guidelines?

D K Vijaykumar, Sujana Arun, Aswin G Abraham, Wilma Hopman, Andrew G Robinson, Christopher M Booth

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of global oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

D K VijaykumarAmrita Institute of Medical Sciences and Research Centre, Cochin, India.
Sujana ArunAmrita Institute of Medical Sciences and Research Centre, Cochin, India.
Aswin G AbrahamAmrita Institute of Medical Sciences and Research Centre, Cochin, India.
Wilma HopmanKingston General Hospital Research Institute, Kingston, Ontario, Canada.
Andrew G RobinsonQueen's University Cancer Research Institute, Kingston, Ontario, Canada.
Christopher M BoothQueen's University Cancer Research Institute, Kingston, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe National Cancer Grid (NCG) of India has recently published clinical practice guidelines that are relevant in the Indian context. We evaluated the extent to which breast cancer care at a teaching hospital in South India was concordant with NCG guidelines.

methodsAll patients who had surgery for breast cancer at a single center from January 2014 to December 2015 were included. Demographic, pathologic, and treatment characteristics were extracted from the electronic medical record. Patients were classified as being concordant with six elements selected from the NCG guideline. The indicators related to appropriate use of sentinel lymph node (SLN) biopsy, lymph node harvest, adjuvant radiotherapy, adjuvant chemotherapy, human epidermal growth factor receptor 2 (HER2) testing, and delivery of adjuvant trastuzumab.

resultsA total of 401 women underwent surgery for breast cancer; mean age (standard deviation) was 57 (12) years. Lymph node involvement was present in 47% (188 of 401) of the cohort; 23% (94 of 401) had T1 disease. Ninety-two percent (368 of 401) underwent radical modified mastectomy. SLN biopsy was performed in 75% (167 of 222) of eligible patients. Eighty percent (208 of 261) of patients with a positive SLN biopsy or no SLN biopsy had a lymph node harvest of more than 10. Adjuvant chemotherapy with an anthracycline and a taxane was delivered to 67% of patients (118 of 177) with node-positive disease. Adjuvant radiotherapy was delivered to 84% (180 of 213) of patients with breast-conserving surgery, T4 tumors, or 3+ positive lymph nodes. Fluorescent in situ hybridization testing was performed in 59% of patients (43 of 73) with 2+ HER2-positive lymph nodes on immunohistochemistry. Among patients with HER2 overexpression, 40% (36 of 91) received adjuvant trastuzumab.

conclusionConcordance with NCG guidelines for breast cancer care ranged from 40% to 84%. Guideline concordance was lowest for those elements of care associated with the highest direct costs to patients.

Indexed as

AdultAgedAged, 80 and overBenchmarkingBreast NeoplasmsChemotherapy, AdjuvantElectronic Health RecordsErb-b2 Receptor Tyrosine KinasesFemaleHospitals, TeachingHumansIndiaMastectomyMiddle AgedPractice Guidelines as TopicRadiotherapy, AdjuvantERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesTrastuzumab

Identifiers

PMID31260396
PMCPMC6613671

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.