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Laeknabladid ; 106(9): 397-402, 2020 Sep.
Article in Icelandic | MEDLINE | ID: mdl-32902398

ABSTRACT

PURPOSE: As part of the implementation of quality registration in Iceland we used retrospective data to compare diagnosis and treatment of invasive breast cancer between Iceland and Sweden. MATERIALS AND METHODS: Information on all patients diagnosed with invasive breast cancer in Iceland 2016-2017 was obtained from the Icelandic Cancer Registry. Hospital records were used to register variables in an electronic form adapted from the Swedish quality registration, and compared with data from Sweden for the same period. A chi-square test was used to compare ratios. RESULTS: A total of 486 cases of breast cancer were diagnosed in Iceland and 15.325 in Sweden. A lower proportion of 40-69 year old women were diagnosed within the screening programme in Iceland (46%) compared to Sweden (60%) (p<0.01). Multidisciplinary tumor board meetings held before and after surgery were less frequent in Iceland (92% vs. 96%) compared to Sweden (98% vs. 99%) in 2016 (p<0,01) but no difference was seen in 2017. A sentinel node surgery was done in 69% of the cases in Iceland compared to 94% in Sweden (p<0,01). For cancers ≤30mm breast conserving surgery was done in 48% cases in Iceland but 80% in Sweden (p<0,01). In Iceland 87% of the cases had radiation therapy after breast conserving surgery but 94% in Sweden (p<0,01). Among mastectomy patients with lymph node metastases, 49% received radiation therapy in Iceland compared to 83% in Sweden (p<0,01). CONCLUSION: Differences were seen in several areas of diagnosis and treatment of invasive breast cancer between Iceland and Sweden. With quality registration it will be possible to monitor and set goals for the diagnosis and treatment, with the aim of providing the best treatment to as many patients as possible.


Subject(s)
Breast Neoplasms/diagnosis , Breast Neoplasms/surgery , Early Detection of Cancer/trends , Healthcare Disparities/trends , Mastectomy/trends , Practice Patterns, Physicians'/trends , Adult , Aged , Breast Neoplasms/epidemiology , Breast Neoplasms/pathology , Female , Humans , Iceland/epidemiology , Lymphatic Metastasis , Mastectomy/adverse effects , Middle Aged , Neoplasm Invasiveness , Predictive Value of Tests , Quality Indicators, Health Care/trends , Radiotherapy, Adjuvant/trends , Registries , Retrospective Studies , Sweden/epidemiology , Time Factors , Treatment Outcome , Tumor Burden
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