The National Audit of Breast Cancer in Older Patients (NABCOP) is a joint project involving the Association of Breast Surgery (ABS) and the Clinical Effectiveness Unit of the Royal College of Surgeons of England. This is an HQIP sponsored audit.
You can download a copy of the NABCOP Annual Report 2017 here.
You can find more information on the NABCOP website here www.nabcop.org.uk.
The Sloane Project is a Public Health England (PHE) funded audit of screen-detected ductal carcinoma in situ (DCIS), lobular in situ neoplasia (LISN) and atypical hyperplasias of the breast, set up in collaboration with the Association of Breast Surgery.
The main aim of the Sloane Project is to gain a greater understanding of the diagnosis, treatment and clinical outcomes of screen detected breast carcinoma in situ and atypical hyperplasia to enable patients and health care professionals to make more informed choices regarding treatment options in the future.
The first phase of the project ran from 1st April 2003 to 31st March 2012 and collected data on DCIS, LISN and ADH. The second phase commenced on 1st April 2012 with a focus on risk lesions and atypia (LISN, ADH, Pleomorphic LCIS (PLCIS), and Flat Epithelial Atypia (FEA)). Patients with DCIS are no longer accrued to the study, although we continue to collect outcome data for all Sloane Project patients entered.
All breast screening services are invited to submit their cases. All data collection forms are available on the Sloane Project website and are straightforward to complete, as in many cases the women will either have one surgical operation or will have no surgical procedure and core/mammotome only. The protocol for identifying and submitting these cases is also available on the website.
Project management and data analyses are provided by Karen Clements and Bridget Hilton at PHE Birmingham, led by Olive Kearins. The project is overseen by a steering group, made up of clinicians, academics, management staff and a patient advocate (full list on website). The Chair is Prof Alastair Thompson, Professor of Surgery, University of Texas MD Anderson Cancer Center/University of Dundee.
The audit has collected comprehensive data on the radiological and pathological features, treatment and follow-up data on over 13,000 patients since it began in April 2003 making it the largest dataset of its kind in the world. Results from the audit have already had an impact on the diagnosis and management of DCIS in the UK and internationally.
A national audit of provision and outcomes of mastectomy and breast reconstruction surgery for women in England and Wales.
The National Mastectomy and Breast Reconstruction Audit was commissioned and funded by the Healthcare Commission to assess and improve the quality of care provided to women with breast cancer undergoing mastectomy and breast reconstruction surgery. The audit evaluated the care process and measured treatment outcomes for these women.
What were the aims of the audit?
- described provision of and access to breast reconstruction in England and Wales
- evaluated current clinical practice in mastectomy and breast reconstruction
- measured outcomes following mastectomy with or without reconstruction
- assessed the quality of information provided to women undergoing mastectomy and their satisfaction with the reconstructive choices made.
Who carried out the audit?
The audit was conducted by a team of specialist clinicians and auditors from:
- the Association of Breast Surgery (Lead Breast Surgeon - Jerome Pereira)
- the British Association of Plastic, Reconstructive and Aesthetic Surgeons (Lead Plastic Surgeon - Chris Caddy)
- the Royal College of Nursing (Lead Specialist Nurse - Carmel Sheppard)
- the National Clinical Audit Support Programme (NCASP) of The Information Centre for health and social care
- the Clinical Effectiveness Unit of The Royal College of Surgeons of England and London School of Hygiene and Tropical Medicine.
The National Mastectomy and Breast Reconstruction Audit produced 4 Annual Reports which you can view here.
The UK National Flap Registry (UKNFR) is a registry for all pedicled and free flaps in the breast, head, neck, upper and lower limb, perineum, trunk and after sarcoma resection. UKNFR has official participation from BAPRAS, BAOMS, BAHNO and the ABS.
The registry, which has been live for all of the UK since August 2015, has now registered 1821 cases and 68 hospitals across the UK are participating. The UKNFR system was subject to months of testing by surgeons from several large UK plastics and maxillofacial units. PROMs have been built in and, for breast surgery, the Breast Q reconstructive modules are sent directly to the patient at six and 18 months via an automated text/e-mail and collated centrally, removing the human interface.
The 'Surgeon Dashboard' was launched in July 2017 and every user/surgeon can download various graphs (numbers, case mix, gender, age, success rate, return to theatre) for appraisal and revalidation.
Surgical societies in Sweden, Finland, Holland and Belgium have expressed an interest in establishing similar flap registries and there is also hope of setting up an international collaboration of flap registries (ICNFR), in a manner similar to the international collaboration of breast implant registries (icobra), allowing comparison of international outcomes.
Terms and Conditions, User Policy, Patient information sheet and consent form are uploaded in the documents section of UKNFR website. To visit the live registry please click here.
To download information and tips please click here.
Once they have enough cases surgeons will be able to download/export their own data and generate funnel plots and graphs for presentation in appraisals and for revalidation.
The Breast Cancer Clinical Outcome Measures (BCCOM) Project aimed to audit the clinical management of symptomatic breast cancers in the United Kingdom. The information needed for the audit was obtained from existing sources such as the data currently collected by cancer registries and individual clinicians. The audit was conducted in collaboration with the UK cancer registries and 191 breast surgeons registered with the UK Association of Breast Surgery at BASO (now the Association of Breast Surgery).
Please be aware that:
- BCCOM only covered the first invasive breast tumour diagnosed in a patient in that year, so not all tumours were potentially audited
- BCCOM relied upon the goodwill/time of clinicians to complete this in their own time; response rates varied by hospital and over time
- BCCOM was not a compulsory audit and only cover ~40% of tumours diagnosed in each audited period, so the results may not be representative of the whole patient (or clinical) communities
- For these reasons alone, the results from BCCOM should not be directly compared to those of a compulsory data-driven audit like NABCOP
Below you can download copies of the All Breast Cancer Report and BCCOM booklets.