{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:36:07Z","timestamp":1760315767958,"version":"build-2065373602"},"reference-count":24,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There are few quality metrics and benchmarks specific to surgical oncology. Development of a surgeon\u2010level performance metrics system based on peer comparisons is hypothesized to positively influence surgical decision\u2010making. This study established a tracking and reporting system comprised of evidence and consensus\u2010based metrics to assess breast care delivered by individual surgeons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Surgeons\u2019 performance is assessed by a surveillance tracking system of metrics pertaining to referrals and surgical elements. This retrospective analysis of prospectively collected breast care data reports on recurring 6\u2010month and cumulative data from nine care locations from 2015 to 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Breast care was provided to 6659 patients by 41 surgeons. A total of 27 breast care metrics were evaluated over 7 years. Metrics with consistent, proficient results were retired after 18 months, including the rate of core biopsy, specimen orientation, and referrals to medical oncology, genetics, and fertility, among others. In clinically node\u2010negative, hormone receptor\u2010positive patients 70 years of age or older, the cumulative rate of sentinel lymph node (SLN) biopsy significantly decreased by 40% over 5.5 years (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). The overall breast conservation rate for T0\u2013T2 cancer increased 10% over 7 years. At the surgeon level, improvements were made in the median number of SLNs removed and in operative note documentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Implementation of a surgeon\u2010specific, peer comparison\u2010based metric and tracking system has yielded substantive changes in breast care management. This process and governance structure can serve as a model for quantification of breast care at other institutions and for other disease sites.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34924","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T07:06:39Z","timestamp":1688022399000},"page":"3230-3238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing trends in breast care surveillance metrics after implementing surgeon\u2010specific tracking and performance reporting in a large, integrated cancer network"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6559-8312","authenticated-orcid":false,"suffix":"Jr","given":"Richard L.","family":"White","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology Department of Surgery Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle L.","family":"Wallander","sequence":"additional","affiliation":[{"name":"Clinical Trials Office Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjorie E.","family":"Leighliter","sequence":"additional","affiliation":[{"name":"Breast Clinic Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Sha","sequence":"additional","affiliation":[{"name":"Department of Cancer Biostatistics Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pooja P.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Division of Community and Social Impact Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Almira","family":"Sejdic","sequence":"additional","affiliation":[{"name":"Department of Cancer Biostatistics Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer H.","family":"Benbow","sequence":"additional","affiliation":[{"name":"Clinical Trials Office Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deba","family":"Sarma","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Department of Surgery Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myra M.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Cancer Biostatistics Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally J.","family":"Trufan","sequence":"additional","affiliation":[{"name":"Department of Cancer Biostatistics Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry","family":"Sarantou","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Department of Surgery Levine Cancer Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"United States Centers for Medicare and Medicaid Services.MACRA. Accessed September 26 2022.https:\/\/www.cms.gov\/medicare\/quality-initiatives-patient-assessment-instruments\/value-based-programs\/macra-mips-and-apms\/macra-mips-and-apms"},{"key":"e_1_2_9_3_1","unstructured":"United States Centers for Medicare and Medicaid Services.Quality Payment Program. Accessed September 26 2022.https:\/\/qpp.cms.gov\/mips\/explore-measures?tab=qualityMeasures&py=2022#measures"},{"key":"e_1_2_9_4_1","unstructured":"Commission on Cancer.Optimal Resources for Cancer Care 2020 Standards;April 2022. Accessed August 15 2022.https:\/\/www.facs.org\/media\/whmfnppx\/2020_coc_standards.pdf"},{"key":"e_1_2_9_5_1","unstructured":"American College of Surgeons.National Accreditation Program For Breast Centers Standards Manual;2018. Accessed August 15 2022.https:\/\/www.facs.org\/media\/pofgxojm\/napbc_standards_manual_2018.pdf"},{"key":"e_1_2_9_6_1","unstructured":"American College of Surgeons and the Commision on Cancer.Cancer Quality Improvement Program (CQIP). 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Accessed June 28 2022.https:\/\/www.choosingwisely.org\/clinician-lists\/sso-sentinel-node-biopsy-in-node-negative-women-70-and-over\/"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4759-x"},{"volume-title":"Operative Standards for Cancer Surgery: Breast, Lung, Pancrease, Colon","year":"2015","author":"American College of Surgeons Cancer Research Program, Alliance for Clinical Trials in Oncology","key":"e_1_2_9_12_1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.4508"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2015.0647"},{"key":"e_1_2_9_15_1","unstructured":"American College of Surgeons.Cancer Surgery Standards Program.\u00a0Accessed November 3 2022.https:\/\/www.facs.org\/quality-programs\/cancer-programs\/cancer-surgery-standards-program\/"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-4086-7"},{"key":"e_1_2_9_17_1","unstructured":"American College of Surgeons.NCDB Announces New Breast Quality Measure. 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