{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:29:24Z","timestamp":1790422164148,"version":"4.1.0"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T00:00:00Z","timestamp":1704758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Innovationsfonds des Gemeinsamen Bundesausschuss","award":["F\u00f6rderkennzeichen 01VSF17020"],"award-info":[{"award-number":["F\u00f6rderkennzeichen 01VSF17020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Certified breast cancer centers offer specific quality standards in terms of their structure, diagnostic and treatment approaches with regards to breast surgery, drug-based cancer therapy,\n        radiotherapy, and psychosocial support. Such centers aim to improve treatment outcomes of breast cancer patients. The question investigated here was whether patients with primary breast cancer\n        have a longer overall survival if they are treated in a certified breast cancer center compared to treatment outside these centers.<\/jats:p><jats:p>We used patient-specific data (demographics, diagnoses, treatments) obtained from data held by mandatory health insurance companies (gesetzliche\n        Krankenversicherung, GKV) and clinical cancer registries (KKR) for the period 2009\u20132017 as well as hospital characteristics recorded in standardized quality reports. Using multivariable\n        Cox regression analysis, we investigated differences in survival between patients treated in hospitals certified as breast cancers centers by the German Cancer Society (DKG) and patients\n        treated in hospitals which had not been certified by the DKG.<\/jats:p><jats:p>The sample population consisted of 143720 (GKV data) and 59780 (KKR data) patients with breast cancer, who were treated in 1010 hospitals across Germany (280 DKG-certified, 730 not\n        DKG-certified). 63.5% (GKV data) and 66.7% (KKR data) of patients, respectively, were treated in DKG-certified breast cancer centers. Cox regression analysis for overall survival which\n        included patient and hospital characteristics found a significantly lower mortality risk for patients treated in DKG-certified breast cancer centers (GKV data: HR\u00a0=\u00a00.77, 95% CI\u00a0=\u00a00.74\u20130.81;\n        KKR data: HR\u00a0=\u00a00.88, 95% CI\u00a0=\u00a00.85\u20130.92). This result remained stable even after several sensitivity analyses including stratified estimates for subgroups of patients and hospitals. The effect\n        was even more pronounced for recurrence-free survival (KKR data: HR\u00a0=\u00a00.78, 95%\u00a0CI\u00a0=\u00a00.74\u20130.82).<\/jats:p><jats:p>Patients who are treated by an interdisciplinary team in a DKG-certified breast cancer had clear and statistically significantly better survival rates. Certification is therefore an\n        effective means of improving the quality of care, and more patients should be treated in certified breast cancer centers.<\/jats:p>","DOI":"10.1055\/a-1869-1772","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T03:35:16Z","timestamp":1704857716000},"page":"153-163","source":"Crossref","is-referenced-by-count":16,"title":["Treatment in Certified Breast Cancer Centers Improves Chances of Survival of Patients with Breast Cancer"],"prefix":"10.1055","volume":"84","clinical-trial-number":[{"clinical-trial-number":"nct04334239","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6922-7148","authenticated-orcid":false,"given":"Olaf","family":"Schoffer","sequence":"first","affiliation":[{"name":"Zentrum f\u00fcr Evidenzbasierte Gesundheitsversorgung, Universit\u00e4tsklinikum und Medizinische Fakult\u00e4t Carl Gustav Carus an der Technischen Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Wimberger","sequence":"first","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Carl Gustav Carus an der Technischen Universit\u00e4t Dresden, Dresden, Germany"},{"name":"National Center of Tumor Diseases (NCT) Dresden, Dresden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gerken","sequence":"additional","affiliation":[{"name":"Tumorzentrum Regensburg, Zentrum f\u00fcr Qualit\u00e4tssicherung und Versorgungsforschung der Universit\u00e4t Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Bierbaum","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Evidenzbasierte Gesundheitsversorgung, Universit\u00e4tsklinikum und Medizinische Fakult\u00e4t Carl Gustav Carus an der Technischen Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Bobeth","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Evidenzbasierte Gesundheitsversorgung, Universit\u00e4tsklinikum und Medizinische Fakult\u00e4t Carl Gustav Carus an der Technischen Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"R\u00f6\u00dfler","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Evidenzbasierte Gesundheitsversorgung, Universit\u00e4tsklinikum und Medizinische Fakult\u00e4t Carl Gustav Carus an der Technischen Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Dr\u00f6ge","sequence":"additional","affiliation":[{"name":"Wissenschaftliches Institut der AOK, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ruhnke","sequence":"additional","affiliation":[{"name":"Wissenschaftliches Institut der AOK, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"G\u00fcnster","sequence":"additional","affiliation":[{"name":"Wissenschaftliches Institut der AOK, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kees","family":"Kleihues-van Tol","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft Deutscher Tumorzentren e.V., Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Link","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Frauenheilkunde und Geburtshilfe, Universit\u00e4tsklinikum Carl Gustav Carus an der Technischen Universit\u00e4t Dresden, Dresden, Germany"},{"name":"National Center of Tumor Diseases (NCT) Dresden, Dresden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Scharl","sequence":"additional","affiliation":[{"name":"Onkologische Fachklinik Bad Trissl, Oberaudorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth C.","family":"Inwald","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Lehrstuhl der Universit\u00e4t Regensburg, Caritas-Krankenhaus St. Josef, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6531-755X","authenticated-orcid":false,"given":"Karin","family":"Kast","sequence":"additional","affiliation":[{"name":"Zentrum Famili\u00e4rer Brust- und Eierstockkrebs und Centrum f\u00fcr Integrierte Onkologie, Universit\u00e4t zu K\u00f6ln, K\u00f6ln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Papathemelis","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Klinikum St. Marien Amberg, Amberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Ortmann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Lehrstuhl der Universit\u00e4t Regensburg, Caritas-Krankenhaus St. Josef, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Klinkhammer-Schalke","sequence":"additional","affiliation":[{"name":"Tumorzentrum Regensburg, Zentrum f\u00fcr Qualit\u00e4tssicherung und Versorgungsforschung der Universit\u00e4t Regensburg, Regensburg, Germany"},{"name":"Arbeitsgemeinschaft Deutscher Tumorzentren e.V., Berlin, 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A health economic analysis of colon cancer care in Germany using administrative data","volume":"149","author":"CY Cheng","year":"2021","journal-title":"Int J Cancer"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e692","DOI":"10.1111\/j.1463-1318.2012.03145.x","article-title":"Quality of rectal cancer surgery and its relationship to surgeon and hospital caseload: a population-based study","volume":"14","author":"H Comber","year":"2012","journal-title":"Colorectal Dis"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1186\/s13643-016-0376-4","article-title":"Relationship between surgeon volume and outcomes: a systematic review of systematic reviews","volume":"5","author":"J Morche","year":"2016","journal-title":"Syst Rev"}],"container-title":["Geburtshilfe und Frauenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1869-1772.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T14:07:36Z","timestamp":1730815656000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1869-1772"}},"subtitle":["Evidence Based on Health Care Data from the WiZen Study"],"short-title":[],"issued":{"date-parts":[[2024,1,9]]},"references-count":24,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2024,2,8]]},"published-print":{"date-parts":[[2024,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1869-1772","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0016-5751","1438-8804"],"issn-type":[{"value":"0016-5751","type":"print"},{"value":"1438-8804","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,9]]}}}