Abstract
Since 2022, the Commission on Cancer (CoC) has developed three new breast cancer quality measures (QMs): time to surgery (BCSdx) and radiation (BCSRT) and the use of neoadjuvant therapy for triple negative and HER2/neu positive breast cancer (BneoCT). This study assesses CoC center historical performance for these measures and facility factors associated with low performance.
We examined the median number of days for time to surgery and radiation, and the proportion of facilities that achieved an estimated performance rate (EPR) of 70%, 80%, and 90% from 2004 to 2020 for all three measures. Multivariable logistic regression analysis was used to determine the association between facility factors and not achieving 80% EPR for all three measures.
The median number of days to surgery and radiation in 2004 were 16 and 43, respectively, compared with 34 and 48 in 2020 (p < 0.01). For BneoCT, BCSdx, and BCSRT measures, the proportion of facilities that attained ≥ 80% EPR was 68.5%, 72.2%, and 35.2%, respectively. The proportion of facilities that attained ≥ 80% EPR in 2004 was 92.3% for BCSdx and 49.8% for BCSRT compared with 69.6% and 39.4%, respectively, in 2020. BneoCT performance improved over time. Academic facilities and facilities serving a larger proportion of socioeconomically disadvantaged patients were approximately twice as likely to be unable to achieve compliance with all three QMs.
Performance levels for BCSRT are the lowest of all three measures. Academic centers and centers with a higher proportion of Medicaid patients are more likely to have lower adherence with all three QMs.