Sammanfattning
Background. We wanted to check if our routines for diagnosing and treating primary operable breast cancer and ductal carcinoma in situ were concordant with national guidelines and quality standards.
Material and methods. Data were retrospectively collected from medical journals for all relevant patients operated at Ålesund Hospital, Norway from 1.11.02 to 1.05.08.
Results. 487 breasts were operated in 478 patients. A triple-diagnostic approach (mammography/ultrasound, clinical examination and biopsy) was used in 98 % of patients and ultrasound-guided core-needle-biopsy in 86 %. For 82 % of patients one visit in an out-patient-department was enough to conclude with a malignant diagnosis. A sentinel node biopsy was taken for 378 of 457 (83 %) patients operated in the axilla; a sentinel node was found in 93 % of them. Three (median) sentinel nodes were removed (spread in the range 1 - 12). 51 % of patients had breast-conserving surgery. From diagnosis of cancer to completion of all surgical procedures, 57 patients (12 %) had two operations, three (0.6 %) had three operations (in the breast and axilla), and 89 % of patients had completed all surgery within three weeks.13 % of patients had postoperative complications. After axillary lymph-node dissection, 20 % of patients had lymph-oedema/shoulder/arm pain. Three patients had ipsilateral relapse in the breast or thoracic wall. None had axillary relapse after sentinel-node biopsy. The median observation time was 26 months (0 - 66 months).
Interpretation. The results of diagnosis and treatment in our hospital are in good accordance with our national guidelines and quality standards.