Conservation rates of breast and axilla indicate the quality of surgical management of the early-stage breast cancer patient

Background: Multidisciplinary care in quality-assured specialized Brest Centre is nowadays considered optimal management of breast cancer and it is associated with better patient outcomes. Modern breast cancer surgery should provide optimal oncological outcomes, as well as preserve the quality of life. European Society of Breast Cancer Specialists (EUSOMA) set up the minimum requirements for a specialized Breast Centre and proposed 15 mandatory quality indicator (QI) benchmarks for certification purposes. Six are intended for breast cancer surgery quality assessment. Methods: In Breast Centre of Clinical Hospital Centre Rijeka, Croatia, data were collected retrospectively for 2019 and prospectively thereafter in a clinical register, encrypted according to the EUSOMA instructions and uploaded into the collective EUSOMA database. Following database validation, all quality indicators were calculated, for 3 consecutive years. In addition, a comprehensive on-site audit was performed in 2021 for all services included in breast cancer management in Rijeka, Croatia. Results: All mandatory surgical quality indicators were above the EUSOMA benchmarks in all 3 years. Non-compliance with EUSOMA recommendations were reported as major, minor, recommendations and observations. For the surgical department, no major or minor non-conformities were reported. At the national level, mastectomy rates were above the permitted benchmark in 4 consecutive years. Conclusion: We have voluntarily initiated and performed quality control of our Breast Centre. The achieved certificate is a confirmation of the high quality of care. All Centers involved in breast cancer management should consider quality evaluation to detect potential suboptimal management. Improvements in quality of care will improve patient outcomes.