Adherence to NCCN Breast Cancer Guidelines Improves Outcomes

Samantha DiGrande

In a study presented at the American Society of Clinical Oncology Quality Care Symposium last month, researchers looked to assess the adherence to National Comprehensive Cancer Network (NCCN) guidelines in the neoadjuvant treatment of breast cancer and the impact on outcomes. 

Raju Kumar Vaddepally, MBBS, MD, and fellow study authors screened patients who were treated with neoadjuvant chemotherapy at the Henry Ford Health System in Detroit, Michigan during 2015 to 2016. In total, 46 patients met the criteria of the study. 
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In order to evaluate adherence, the authors created 8 adherence categories per NCCN’s guidelines. Total adherence rate was calculated by dividing the number of categories for which they underwent intervention by the total number of eligible adherence categories. Additionally, rates of pathologic complete response and breast conservation surgery were calculated to measure the outcomes. 

In total, researchers enrolled 9 triple negative breast cancer, 28 human epidermal growth factor receptor 2 (HER2) positive, and 17 triple positive patients. The authors found that there was 100% adherence in categories such as appropriate pre-chemotherapy evaluation (n = 46), completeness of histopathology report (n = 46), use of anti-HER2 antibody drug in patients with HER2 positive breast cancer (n = 28), and adjuvant radiation therapy (n = 39). 

In other categories, adherence differed. Specifically, in genetic consult researchers found 70% adherence (n = 33), 69% (n = 32) in reconstructive surgery, and 65% (n = 46) in cancer distress screening performed. 

The study also found that the pathologic complete response rate was 39%, and the breast conservation surgery rate was 41%. Overall, the results showed that adherence to NCCN guidelines leads to improve outcomes. 

Going forward, the authors recommend that “to improve the quality of care, institutions should closely monitor the adherence to NCCN or other alternative national guidelines.”


Kumar Vaddepally R. Institutional adherence to National Comprehensive Cancer Network guidelines in neoadjuvant treatment of breast cancer and its correlation to outcomes. Presented at the American Society of Clinical Oncology Quality Care Symposium, September 28-29, 2018; Phoenix, Arizona. AB47. 
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