Effects of guideline adherence in primary breast cancer--a 5-year multi-center cohort study of 3976 patients

Breast. 2010 Apr;19(2):120-7. doi: 10.1016/j.breast.2009.12.006. Epub 2010 Feb 1.


Background: The aim of that study was to analyze the impact of German-S3-breast cancer guideline adherence on clinical outcomes.

Methods: A retrospective study analyzed 3976 patients first diagnosed with primary breast cancer according to an S3-guideline-based model that classified patients retrospectively into groups receiving "guideline-adherent and "guideline non-adherent" therapy.

Results: There was a significant association between treatment adherence and prolonged recurrence free and overall survival (p = 0.0001). The greater the number of violations in guideline adherence, the lower was overall survival (p = 0.0001). Advanced age at initial diagnosis was additionally associated with a reduction in guideline adherence. The percentage of guideline adherence for the therapeutic modalities BCT, mastectomy, axillary dissection and hormone therapy was greater than 80%. For chemotherapy, the percent of guideline adherence totaled 71.4%.

Conclusion: Therapies dispensed in adherence with guidelines may improve recurrence-free survival and overall survival in patients with breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / therapy*
  • Cohort Studies
  • Female
  • Guideline Adherence*
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome