Timeliness of Breast Diagnostic Imaging and Biopsy in Practice: 15 Years of Collecting, Comparing, and Defining Quality Breast Cancer Care.

BACKGROUND: The literature lacks well-established benchmarks for expected time between screening mammogram to diagnostic imaging and then to core needle breast biopsy. METHODS: Timeliness of diagnostic imaging workup was evaluated using aggregate data from 2005 to 2019 submitted to The National Quality Measures for Breast Centers (NQMBC). RESULTS: A total of 419 breast centers submitted data for 1,805,515 patients on the time from screening mammogram to diagnostic imaging. The overall time was 7 days with 75th, 25th, and 10th percentile values of 5, 10, and 13.5 days, respectively. The average time in business days decreased from 9.1 to 7.1 days (p < 0.001) over the study period with the greatest gains in poorest-performing quartiles. Screening centers and centers in the Midwest had significantly shorter time to diagnostic imaging. Time from diagnostic imaging to core needle biopsy was submitted by 406 facilities representing 386,077 patients. The average time was 6 business days, with 75th, 25th, and 10th percentiles of 4, 9, and 13.7 days, respectively. Time to biopsy improved from a mean of 9.0 to 6.3 days (p < 0.001) with the most improvement in the poorest-performing quartiles. Screening centers, centers in the Midwest, and centers in metropolitan areas had significantly shorter time to biopsy. CONCLUSIONS: In a robust dataset, the time from screening mammogram to diagnostic imaging and from diagnostic imaging to biopsy decreased from 2005 to 2019. On average, patients could expect to have diagnostic imaging and biopsies within 1 week of abnormal results. Monitoring and comparing performance with reported data may improve quality in breast care.

Influencing Quality Reporting: Using the Rapid Quality Reporting System in a Community Network
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BACKGROUND: Value-based cancer care warrants an exploration of ways that nurses can influence quality for patients with cancer, particularly in the community setting, where the majority of patients with cancer are treated.
. OBJECTIVES: The purpose is to explore how community cancer centers met and sustained key quality breast cancer care indicators through implementation of the National Cancer Institute Community Cancer Centers Program Rapid Quality Reporting System (RQRS) and patient navigation projects.
. METHODS: The authors identified and interviewed staff at three sites that achieved significant increases in concordance with three breast cancer outcome measures. FINDINGS: Three main themes emerged through analysis.