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. 2023 Oct;30(10):6070-6078.
doi: 10.1245/s10434-023-13905-6. Epub 2023 Aug 1.

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

Cory Amanda Donovan  1 , Cary S Kaufman  2 , Kari A Thomas  3 , Ayfer Kamali Polat  4 , Marguerite Thomas  5 , Bonnie Mack  6 , Ariel Gilbert  7 , Terry Sarantou  8
Affiliations

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

Cory Amanda Donovan et al. Ann Surg Oncol. 2023 Oct.

Abstract

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.

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Figures

Fig. 1
Fig. 1
Quality measure: all levels can improve when they compare themselves
Fig. 2
Fig. 2
Aggregate data reported to the NQMBC by participating organizations on time from screening to diagnostic mammogram from 2005 to 2019
Fig. 3
Fig. 3
NQMBC aggregate data by quintile from 2005 to 2019 for time from screening to diagnostic imaging by quintile. The quintile reflecting centers with the shortest times to diagnostic imaging is represented in red, while the quintile for centers with the longest times to diagnostic imaging is represented in pink.
Fig. 4
Fig. 4
Overall aggregated data from 2005 to 2019 for time from diagnostic mammogram to core needle biopsy
Fig. 5
Fig. 5
Time from diagnostic imaging to core needle biopsy by quintile. The quintile reflecting centers with the shortest times to biopsy is represented in red, while the quintile for centers with the longest times to biopsy is represented in pink
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