Outcome Measures
Here is the list of the main outcome measures in QT:
**PO1**. PRE-OPERATIVE DIAGNOSIS - Positive or suspicious pre-operative cyto/histological diagnosis
Q.T. calculates the proportion of invasive or in situ operated patients who had had a positive or suspicious pre-operative cytological (C4, C5) or histological (B4, B5) diagnosis for cancer, out of the total number of invasive or in situ operated patients about whom we know whether they performed or not an FNA or a core biopsy or a tru-cut before the intervention. Q.T. calculates separately the number of patients for whom it is not known whether they had a pre-operative diagnosis or which was this diagnosis. **Fields used**: N00, I01,D08,D09
**Eligible cases**: (I01 IN (2,3,4)) AND (N00 IN (1,9) OR ISNULL(N00))
of which at **denominator**: DIAPRE IN (0,1,2,3,4,5) of which at **numerator**: DIAPRE IN (4,5) **PO2**. PRE-OPERATIVE DIAGNOSIS - Positive pre-operative cyto/histological diagnosis
Q.T. calculates the proportion of invasive or in situ operated patients who had had a positive pre-operative cytological (C5) or histological (B5) diagnosis for cancer, out of the total number of invasive or in situ operated patients about whom we know whether they performed or not an FNA or a core biopsy or a tru-cut before the intervention. Q.T. calculates separately the number of patients for whom it is not known whether they had a pre-operative diagnosis or which was this diagnosis. **Fields used**: N00, I01,D08,D09
**Eligible cases**: (I01 IN (2,3,4)) AND (N00 IN (1,9) OR ISNULL(N00))
of which at **denominator**: DIAPRE IN (0,1,2,3,4,5) of which at **numerator**: DIAPRE=5 **11**. Correct excision at 1st surgical biopsy
Q.T. calculates the proportion of patients with impalpable lesions (benign or malignant) which were correctly excised at the first surgical biopsy, out of the total number of patients operated on for impalpable lesions. Q.T. calculates separately: the number of patients with impalpable lesions for whom it is not known if they were excised correctly at the first surgical biopsy. It should be noted that the issue here is not the state of the margins but the fact that there was a failed biopsy (i.e. the mammogram following the biopsy shows the same lesion as was identified at the diagnostic mammogram). Consider that successive operations on the lesion may not be carried out in the department where the failed biopsy was carried out. **Fields used**: H07, N00, D12
**Eligible cases**: D12=0 AND (N00=1 OR ISNULL(N00))
of which at **denominator**: H07 IN (0,1) of which at **numerator**: H07 = 0 **12C**. Immediate reconstruction done
Q.T. calculates the proportion of patients with invasive or in situ carcinoma who had mastectomies and immediate reconstruction, out of the total number of patients with mastectomy about whom the information is available. **Fields used**: I01, H04, ULTINT
**Eligible cases**: I01 IN (2,3,4,5) AND ULTINT IN (5,6,7)
of which at **denominator**: (NOT ISNULL(H04) AND H04<9) OR ULTINT=7 of which at **numerator**: H04=1 OR ULTINT=7 **13A**. Single operation following pre-operative diagnosis of Ca (C4,C5,B4,B5)
Q.T. calculates the proportion of patients whose first operation was not followed by further local operations because of incomplete excision (excluding failed biopsies) out of the total number of patients who were operated for localised invasive or in situ carcinoma with a positive or suspicious cytological or histological pre-operative diagnosis. The number of patients with the same characteristics about whom there is no information about the number of operations or about the re-operation reason is indicated separately. **Fields used**: N00, I01, D08, D09, H01, H02, B03
**Eligible cases**: (N00 IN (1,9) OR ISNULL(N00)) AND (I01 IN (2,3,4)) AND ((D09 IN (4,5)) OR ((D09 IN (0,1,9) OR ISNULL(D09)) AND D08 IN (4,5))) AND NOT (B03=3)
of which at **denominator**: H01=1 OR (H01 IN (2,3) AND (H02 IN (1,2,3,4,5))) of which at **numerator**: H01=1 OR (H01 IN (2,3) AND (H02 IN (1,4))) **14**. Ductal carcinoma in situ (DCIS) without axillary dissection
Q.T. calculates the proportion of patients diagnosed with DCIS or not otherwise specified carcinoma in situ (microinvasive cancer excluded) on whom no axillary dissection has been carried out (not even Level 1), out of the total number of patients operated on with this diagnosis. The number of patients with the same diagnosis about whom there is no information about whether there has been an axillary dissection or not, is indicated separately. **Fields used**: I01, I11, G01, B03
**Eligible cases**: I01 = 2 AND (i11<10 OR ISNULL(I11<10)) AND NOT B03=3
of which at **denominator**: G01 IN (0,1) of which at **numerator**: G01=0 **15A**. Breast conservation surgery in pT1 cases
Q.T. calculates the proportion of patients diagnosed with invasive breast carcinoma of whole pathological size (including DCIS extending < 1 mm beyond invasive area, according to the European Pathology Guidelines) equal to or less than 20 mm (pT1, microinvasive included), not clinically multicentric or multifocal, who were given breast conservation surgery . The denominator is the total number of women operated on with the same diagnosis. The number of patients with the same diagnosis about whom there is no information about the type of operation carried out is indicated separately. **Fields used**: I01, ULTINT, D11, PT, I22, B03
**Eligible cases**: (I01 IN (3,4)) AND (D11 IN (0,9) OR ISNULL(D11)) AND (PT IN (1,1A,1B,1C)) AND (NOT (I22<20 AND I22<999) OR ISNULL(I22)) AND (NOT (B03=3))
of which at **denominator**: ULTINT IN (1,2,3,4,5,6,7) of which at **numerator**: ULTINT IN (1,2,3,4) **15B**. Breast conservation surgery in carcinoma in situ = 20 mm.
Q.T. calculates the proportion of patients diagnosed with breast carcinoma in situ of pathological diameter equal to or less than 20 mm, not clinically multicentric or multifocal, operated on with conservation surgery, out of the total number of women operated on with the same diagnosis. The number of patients with the same diagnosis about whom there is no information about the type of operation carried out is indicated separately. **Fields used**: I01, ULTINT, D11, PT, I21, D16, I22, B03
**Eligible cases**: PT=IS AND (D11 IN (0,9) OR ISNULL(D11)) AND ((I21<=0 AND I21<=20) OR ((ISNULL(I21) OR (I21=999)) AND (D16<=20 OR D16=999 OR ISNULL(D16)))) AND (NOT (I22<20 AND I22<999) OR ISNULL(I22)) AND NOT (B03=3)
of which at **denominator**: ULTINT IN (1,2,3,4,5,6,7) of which at **numerator**: ULTINT IN (1,2,3,4) **16B3**. Clear margins (>1 mm) after last operation
Q.T. calculates the proportion of conservation operations (last conservation operation if more than one) for invasive or in situ cancer which ensured clear margins (distance > 1 mm from the lesion), out of the total of conservation operations done. The number of patients who had conservation surgery and about whom the state of the margins is unknown is indicated separately. If the distance in mm is missing but in the pathologist’s judgement margins are clear, this assessment is used. **Fields used**: I01, ULTINT, I23, I24, I25A, I23B, I24B, I25B
**Eligible cases**: I01 IN (2,3,4) AND (ULTINT<5 AND NOT ISNULL(ULTINT))
of which at **denominator**: (I23 = 1) OR ((I23=9 OR ISNULL(I29)) AND NOT ((I24=999 OR ISNULL(I24)) AND (I25A=999 OR ISNULL(I25A)))) OR (I23 = 2 AND NOT ((ISNULL(I24) OR I24=999))) OR (I23 = 5 AND NOT ((ISNULL(I25A) OR I25A=999))) OR (I23 IN (3,4,6,7)) of which at **numerator**: (I23=1 AND ((I24<1 AND ISNULL(I25A)) OR (I25A<1 AND ISNULL(I24)) OR (I24<1 AND I25A<1) OR (ISNULL(I24) AND ISNULL(I25A)))) OR ((I23 =9 OR ISNULL(I23)) AND ((I24<1 AND ISNULL(I25A)) OR (I25A<1 AND ISNULL(I24)) OR (I24<1 AND I25A<1) )) OR (I23=2 AND I24<1) **17B**. No frozen section if tumour diameter <= 10 mm
Q.T. calculates the proportion of patients operated on for invasive breast carcinoma (excluding microinvasive cancer) of a maximum pathological size inferior or equal to 10 mm for which there was no frozen section, out of the total number of patients with the same diagnosis. The number of patients with the same diagnosis about whom there is no information is indicated separately. **Fields used**: I01, N00, PT, E14, E15, D16, I21, I22, I26
**Eligible cases**: (N00=1 OR ISNULL(N00)) AND (I01=4) AND (PT IN (1A,1B))
of which at **denominator**: E14 IN (0,1,2,3,4,5) OR E15 IN (0,1,2,3,4,5,6) of which at **numerator**: E14=0 AND (E15 IN (0,9) OR ISNULL(E15)) **18A**. Number of removed lymph nodes > 9
Q.T. calculates the proportion of patients operated on for invasive breast carcinoma and who had an axillary dissection (I-III level) excluding sampling, from whom at least 10 lymph nodes were excised, out of the total number of patients operated for invasive breast carcinoma and who had an axillary dissection. The number of patients about whom there is no information about the number of excised lymph nodes is indicated separately. **Fields used**: I01, G01, G09, I29, B03
**Eligible cases**: I01 IN (3,4) AND G01=1 AND G09 IN (2,3) AND NOT (B03=3)
of which at **denominator**: I29<0 AND I29<99 of which at **numerator**: I29<9 **18C**. hormonal receptors measuring available
Q.T. calculates the proportion of patients operated on for invasive breast carcinoma (excluding microinvasive cancer) for whom measuring was provided, out of the total number of patients operated on for invasive breast carcinoma. The number of patients operated on for invasive breast carcinoma about whom this information is not available is indicated separately. **Fields used**: I01, N00, B03, I38
**Eligible cases**: I01=4 AND (N00=1 OR ISNULL(N00)) AND NOT (B03=3)
of which at **denominator**: I38 IN (0,1,2) of which at **numerator**: I38 IN (1,2) **18D**. Histopathological grading available
Q.T. calculates the proportion of patients operated on for invasive breast carcinoma (excluding microinvasive cancer) for whom measuring was provided, out of the total number of patients operated on for invasive breast carcinoma. The number of patients operated on for invasive breast carcinoma about whom this information is not available is indicated separately. **Fields used**: I01, N00, B03, I08
**Eligible cases**: I01=4 AND (N00=1 OR ISNULL(N00)) AND NOT (B03=3)
of which at **denominator**: I08 IN (0,1,2,3) of which at **numerator**: I08 IN (1,2,3) **21A2**. Operation within 30 days after decision to operate
Q.T. calculates the proportion of patients operated on for the first time for suspicious breast lesions (whatever diagnosis, only patients for whom the first treatment is surgery) within 30 days from surgical referral, out of the total number of patients operated on for suspicious breast lesions about whom the information is available. The number of patients about whom no information is avalaible about the date of the operation nor about the date of surgical referral , is indicated separately. **Fields used**: N00, D24, D23, E05, G07, B03
**Eligible cases**: (N00=1 OR ISNULL(N00)) AND (NOT (D24 IN (4,5,6)) OR ISNULL(D24)) AND NOT (B03 IN (2,3))
of which at **denominator**: (DATEDIFF(d,[D23],[E05])>0 AND (NOT ISNULL(D23)) AND (NOT ISNULL(E05))) OR (DATEDIFF(d,[D23],[G07])>0 AND (NOT ISNULL(D23)) AND (ISNULL(E05)) AND (NOT ISNULL(G07))) of which at **numerator**: (DATEDIFF(d,[D23],[E05])<=30 AND NOT ISNULL(E05)) OR (DATEDIFF(d,[D23],[G07])<=30 AND ISNULL(E05) AND NOT ISNULL(G07)) **21B3**. Operation within 90 days after screening mammogram
Q.T. calculates the proportion of patients operated for the first time for suspicious breast lesions (whatever diagnosis, only patients for whom the first treatment is surgery) within 60 days from the screening mammogram. The denominator is the total number of patients operated on for suspicious breast lesions for whom information is available. The number of patients about whom the date of the operation or of the screening mammogram is unavailable is indicated separately. The calculation of this outcome measure requires the C09 item from the screening section to be completed (screening mammogram date). If all recorded lesions are not identified from that source, it is advised that before calculating the outcome measure, the lesions identified at the screening must be selected by inserting D01=1. **Fields used**: N00, D24, C09, E05, G07, B03, D01, C02
**Eligible cases**: (N00=1 OR ISNULL(N00)) AND (NOT (D24 IN (4,5,6)) OR ISNULL(D24)) AND NOT (B03 IN (2,3)) AND (D01<'2' OR ISNULL(D01)) AND (NOT C02 IN (3,8) OR ISNULL(C02))
of which at **denominator**: (DATEDIFF(d,[C09],[E05])>0 AND (NOT ISNULL(C09)) AND (NOT ISNULL(E05))) OR (DATEDIFF(d,[C09],[G07])>0 AND (NOT ISNULL(C09)) AND (ISNULL(E05)) AND (NOT ISNULL(G07))) of which at **numerator**: (DATEDIFF(d,[C09],[E05])<=90 AND NOT ISNULL(E05)) OR (DATEDIFF(d,[C09],[G07])<=90 AND ISNULL(E05) AND NOT ISNULL(G07)) **21B2**. Operation within 60 days after screening mammogram
Q.T. calculates the proportion of patients operated for the first time for suspicious breast lesions (whatever diagnosis, only patients for whom the first treatment is surgery) within 60 days from the screening mammogram. The denominator is the total number of patients operated on for suspicious breast lesions for whom information is available. The number of patients about whom the date of the operation or of the screening mammogram is unavailable is indicated separately. The calculation of this outcome measure requires the C09 item from the screening section to be completed (screening mammogram date). If all recorded lesions are not identified from that source, it is advised that before calculating the outcome measure, the lesions identified at the screening must be selected by inserting D01=1. **Fields used**: N00, D24, C09, E05, G07, B03, D01, C02
**Eligible cases**: (N00=1 OR ISNULL(N00)) AND (NOT (D24 IN (4,5,6)) OR ISNULL(D24)) AND NOT (B03 IN (2,3)) AND (D01<'2' OR ISNULL(D01)) AND (NOT C02 IN (3,8) OR ISNULL(C02))
of which at **denominator**: (DATEDIFF(d,[C09],[E05])>0 AND (NOT ISNULL(C09)) AND (NOT ISNULL(E05))) OR (DATEDIFF(d,[C09],[G07])>0 AND (NOT ISNULL(C09)) AND (ISNULL(E05)) AND (NOT ISNULL(G07))) of which at **numerator**: (DATEDIFF(d,[C09],[E05])<=60 AND NOT ISNULL(E05)) OR (DATEDIFF(d,[C09],[G07])<=60 AND ISNULL(E05) AND NOT ISNULL(G07)) **28A**. Radiotherapy performed after breast conservation surgery
Q.T. calculates the proportion of patients who had breast conservation surgery for invasive or in situ breast carcinoma and for whom radiotherapy followed, out of the total number of patients with the same diagnosis who had conservation surgery. The number of patients about whom there is no information whether radiotherapy was performed is indicated separately. **Fields used**: I01, N00, ULTINT, L01
**Eligible cases**: (N00=1 OR ISNULL(N00)) AND (I01 IN (2,3,4)) AND (ULTINT<5 AND NOT ISNULL(ULTINT))
of which at **denominator**: L01 IN (0,1,2) of which at **numerator**: L01=1 |