{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:05:44Z","timestamp":1784739944279,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,11,25]],"date-time":"2016-11-25T00:00:00Z","timestamp":1480032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation\u2010wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n\u2009=\u200992) in the Netherlands. Thirty\u2010two quality indicators measuring care structure, processes and outcomes were evaluated over time and compared between hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The NBCA contains data of 56,927 patients (7,649 DCIS and 49,073 invasive cancers). Patients being discussed in pre\u2010 and post\u2010operative multidisciplinary team meetings improved (2011: 83% and 91%; 2014: 98% and 99%, respectively) over the years. Tumour margin positivity rates after breast\u2010conserving surgery for invasive cancer requiring re\u2010operation were consistently low (\u223c5%). Other indicators, for example, the use of an MRI\u2010scan prior to surgery or immediate breast reconstruction following mastectomy showed considerable hospital variation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Results shown an overall high quality of breast cancer care in all hospitals in the Netherlands. For most quality indicators improvement was seen over time, while some indicators showed yet unexplained variation. <jats:italic>J. Surg. Oncol. 2017;115:243\u2013249<\/jats:italic>. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.24516","type":"journal-article","created":{"date-parts":[[2016,11,25]],"date-time":"2016-11-25T08:37:24Z","timestamp":1480063044000},"page":"243-249","source":"Crossref","is-referenced-by-count":75,"title":["Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit"],"prefix":"10.1002","volume":"115","author":[{"given":"Annelotte C.M.","family":"van Bommel","sequence":"first","affiliation":[{"name":"Department of Surgery Leiden University Medical Centre Leiden The Netherlands"},{"name":"Dutch Institute for Clinical Auditing Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline E.R.","family":"Spronk","sequence":"additional","affiliation":[{"name":"Department of Surgery Leiden University Medical Centre Leiden The Netherlands"},{"name":"Dutch Institute for Clinical Auditing Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Jeanne T.F.D.","family":"Vrancken Peeters","sequence":"additional","affiliation":[{"name":"Department of Surgery Netherlands Cancer Institute\/Antoni van Leeuwenhoek Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Jager","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Erasmus MC Cancer Institute, University Medical Centre Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Lobbes","sequence":"additional","affiliation":[{"name":"Department of Radiology Maastricht University Medical Centre Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Maduro","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Groningen, University Medical Centre Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.M.","family":"Mureau","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Erasmus MC Cancer Institute, University Medical Centre Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Schreuder","sequence":"additional","affiliation":[{"name":"Department of Research Comprehensive Cancer Organisation the Netherlands (IKNL) Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolien H.","family":"Smorenburg","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Netherlands Cancer Institute\/Antoni van Leeuwenhoek Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janneke","family":"Verloop","sequence":"additional","affiliation":[{"name":"Department of Research Comprehensive Cancer Organisation the Netherlands (IKNL) Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter J.","family":"Westenend","sequence":"additional","affiliation":[{"name":"Department of Pathology Laboratory for pathology Dordrecht e.o. 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