More than 250 women are diagnosed and/or treated for breast cancer at Coborn Cancer Center or St. Cloud Hospital annually. The professionals providing breast cancer care are committed to maintaining information about outcomes for patients treated in our cancer program. The data used to analyze the patterns and quality of breast cancer care is from the St. Cloud Hospital Cancer Registry. They collect detailed data about diagnosis and treatment. The aim of the registry is to improve cancer treatment.

The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines, National Cancer Data Base (NCDB), Advisory Board Oncology Roundtable and peer-reviewed journals were used to identify the measures and establish benchmarks for evaluating quality breast cancer care. The NCDB, a joint program of the Commission on Cancer (CoC) and the American Cancer Society, is a nationwide oncology outcomes database for more than 1400 CoC approved cancer programs in the United States and Puerto Rico.

The measures below are tracked by our Cancer Registry:

Stage at Diagnosis

Minimally Invasive vs. Surgical Breast Biopsy

Average Time from Biopsy to Diagnosis

Sentinel Lymph Node Biopsy

Breast Conservation Surgery vs. Complete Mastectomy

Survival Rate

Stage at Diagnosis

Measure: AJCC Stage at Diagnosis

Rationale: Women diagnosed with invasive breast cancer at an earlier stage have a better overall survival rate. Early stage diagnosis depends upon participation in screening, i.e. annual mammography, and clinical breast exam. Another contributing factor in early diagnosis is the availability of technology such as breast magnetic resonance imaging (MRI), digital mammography, and specialized, experienced breast care providers.

Population: Women diagnosed and/or treated for breast cancer at St. Cloud Hospital from 2004-2006 are included in this measure. This includes patients seen at St Cloud Hospital, Coborn Cancer Center and the Alexandria Radiation Oncology Unit.

Data Results: This graph compares the stage at diagnosis for St. Cloud Hospital breast cancer patients to state and national statistics from the National Cancer Data Base (NCDB). The NCDB data is from 1305 national hospital cancer registries and 18 Minnesota hospital cancer registries.

Outcome: St. Cloud Hospital breast cancer stage at diagnosis compares favorably to data submitted to the National Cancer Data Base by hospitals in Minnesota and the nation.

© Commission on Cancer, American College of Surgeons (ACOS). NCDB Benchmark Reports, v1.1. Chicago, IL, 2002. The content reproduced from the applications remains the full and exclusive copyrighted property of the ACOS. The ACOS is not responsible for any ancillary or derivative works based on the original Text, Tables, or Figures.

Minimally Invasive vs. Surgical Breast Biopsy

Measure: Percent of patients receiving minimally invasive (stereotactic or ultrasound) biopsy versus surgical biopsy.

Rationale: Stereotactic and ultrasound biopsies are considered to be minimally invasive. Minimally invasive breast biopsies ensure optimal patient management. They take less time to perform, cause less patient discomfort and cosmetic deformity, result in fewer artifacts on subsequent mammography, and are more cost effective than surgical biopsies.

Population: All patients who had a breast biopsy at the St Cloud Hospital in 2006 are included in this measure.

Data Results: This graph depicts the percentage of patients undergoing stereotactic or ultrasound biopsies (minimally invasive biopsies) at St. Cloud Hospital compared with national benchmarks.

Outcome: Not all women are candidates for minimal invasive biopsy procedures. However with the latest technology and experienced professionals, St. Cloud Hospital compares to “best practice” with ninety-seven percent of women able to have minimal invasive procedure.

* The National Average, Ideal, and Best Practice Data were obtained from the Oncology Roundtable 2004, “Benchmarking Clinical Quality.” The SCH data was taken from 2006 cancer registry data and chart review.

Average Time from Biopsy to Diagnosis

Measure: Average length of time from biopsy to reporting of pathology results (pathology turnaround time).

Rationale: Waiting for the pathology results of a breast biopsy is stressful for patients. It is important to obtain pathology results as soon as possible to begin treatment planning.

Population: Female breast cancer patients who underwent breast biopsies at St Cloud Hospital during 2006.

Data Results: This graph compares the pathology turnaround time at St Cloud Hospital to national benchmarks.

Outcome: Few women wait longer than 2 days for breast biopsy results at St. Cloud Hospital. This compares favorably with national data.

For 78% of the breast cases, pathology results were available within one working day of the biopsy procedure and 14% within two working days. For the remaining 8%, pathology results may have taken longer than two days due to physician requesting further tissue analysis.

*The National Average and Ideal Practice Data was obtained from the Oncology Roundtable 2004, “Benchmarking Clinical Quality.” The SCH data was taken from 2006 cancer registry data and chart review.

Sentinel Lymph Node Biopsy

Measure: Percentage of eligible women with breast cancer receiving sentinel lymph node biopsy.

Rationale: A possible advantage of doing sentinel node biopsy is the avoidance of unnecessarily removing lymph nodes that are disease-free thus avoiding long-term complication such as lymphedema (swelling caused by excess fluid build up). In facilities with an experienced sentinel node team, sentinel lymph node biopsy has been adopted as standard of care in axillary lymph node staging for eligible patients.

Population: Women who underwent breast cancer surgery at St. Cloud Hospital in 2006.

Data Results: This graph compares the percentage of eligible patients undergoing sentinel lymph node biopsy at St. Cloud Hospital to national benchmarks.

Outcome: Sentinel node biopsy is standard of care for all eligible women receiving breast cancer surgery at St. Cloud Hospital.

*The Standard of Practice Data was obtained from the Oncology Roundtable 2004, “Benchmarking Clinical Quality.” The SCH data was taken from 2006 cancer registry data and chart review.

Breast Conservation Surgery vs. Complete Mastectomy

Measure: Percent of patients receiving breast conservation surgery versus complete mastectomy.

Rationale: Clinical studies have demonstrated little difference in survival rates of early stage breast cancer patients treated with mastectomy versus lumpectomy and radiation. The number of lumpectomies compared to mastectomies has increased in the last decade. However, recent literature has shown that the number of mastectomies may be increasing, possibly due to the introduction of pre-operative breast magnetic imaging (MRI). St. Cloud Hospital has selected this measure to observe for trends in practice.

Population: Women who underwent breast cancer surgery at St. Cloud Hospital in 2006.

Data Results: This graph compares the percentage of breast patients undergoing lumpectomy at St. Cloud Hospital to state and national statistics from the National Cancer Data Base (NCDB). The NCDB data is from 1305 hospital cancer registries, and the 18 Minnesota hospital cancer registries.

Outcome: The percentage of lumpectomies at St. Cloud Hospital is very similar to state and national data. Lumpectomy rates have historically been lower in rural areas than urban, possibly due to the distance and subsequent travel time to and from radiation facilities.

© Commission on Cancer, American College of Surgeons (ACOS). NCDB Benchmark Reports, v1.1. Chicago, IL, 2002. The content reproduced from the applications remains the full and exclusive copyrighted property of the ACOS. The ACOS is not responsible for any ancillary or derivative works based on the original Text, Tables, or Figures.

Survival Rate

Measure: Five-year observed survival rate. The cumulative survival rate is equal to the percent of women alive five years after breast cancer diagnosis.

Rationale: Monitoring survival rates is one of many tools used to evaluate the quality of care given by a facility.

Population: Breast cancer patients who were diagnosed and/or treated at St Cloud Hospital (including the Alexandria Radiation Unit) from 1998 to 2000 were included in this study. Note: There were an insufficient number of stage IV cases at St. Cloud Hospital to calculate the stage IV survival rate. The NCDB data is from 1328 national hospital cancer registries. The diagnostic years, 1998-2000, represent the most current data available to measure survival rates.

Outcome: St. Cloud Hospital’s five year survival rates for breast cancer compare very favorably with national data.

© Commission on Cancer, American College of Surgeons (ACOS). NCDB Benchmark Reports, v1.1. Chicago, IL, 2002. The content reproduced from the applications remains the full and exclusive copyrighted property of the ACOS. The ACOS is not responsible for any ancillary or derivative works based on the original Text, Tables, or Figures.

Additional Resources

Learn more about the services provided by the St. Cloud Hospital Breast Center

Learn more about breast cancer in our health library

For more information about any of the quality measures above, please contact the St. Cloud Hospital Cancer Registry at 320-229-4907.