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

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. (C) 2009 Elsevier Ltd. All rights reserved.