Breast cancer: Good care in breast centers

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Breast cancer: Good care in breast centers

Thanks to improved early detection, breast cancer is not necessarily a death sentence for women today. The Robert Koch Institute reports about 57,000 new cases and approximately 18,000 deaths per year. 90 percent of those affected can be treated in certified breast centers. A benchmarking report by the German Cancer Society (DKG) and the German Society for Senology (DGS) shows that the quality of the therapy in certified breast centers is very good. Self-help groups, however, complain about the lack of adequate psychosocial care for women.

What are certified breast centers?
Breast centers are special departments in hospitals or associations of institutions in which the diagnosis and therapy of diseases of the female breast - in rare cases also of the male breast - are carried out. It is primarily breast cancer screening, such as mammography, and treatments for breast cancer. Oncology, gynecology, radiology, hematology and other departments work closely together. Breast centers certified by the German Cancer Society (DKG) and the German Society for Senology (DGS) are intended to ensure that those affected are treated here according to the latest state of the art. They are subject to strict guidelines.

Breast cancer screening is also carried out in the breast centers, which can be carried out every two years free of charge for women between the ages of 50 and 69. With mammography, small, imperceptible changes in the breast can be detected. The earlier a breast cancer diagnosis is made, the greater the chances of a cure.

205 breast centers guarantee almost nationwide care in Germany
In Germany there are 205 breast centers at 262 locations that have been awarded a quality seal by the German Cancer Society (DKG) and the German Society for Senology (DGS). For the benchmarking report of the two professional associations, data from around 50,000 patients in breast centers at 246 locations in Germany were evaluated. The data evaluation was supplemented by a survey of over 7,000 patients who were treated in certified breast centers in 2010. 95 percent of respondents said they felt they could rely on their doctor.

Professor Rolf Kreienberg, chair of the DKG certification commission, reports that certified breast centers have concrete guidelines for standardized cancer therapy. Oncologists, surgeons and radiation therapists often work hand in hand in the breast centers so that a better treatment result can be achieved for those affected.

Certified breast centers meet their target criteria
The recently presented benchmarking report by the German Cancer Society (DKG) and the German Society for Senology (DGS) shows the high quality of the breast centers. Kreienberg gives as an example the target specifications for the treatment of patients with positive lymph node involvement: In the certified breast centers, 86.5 percent of those affected were treated with chemotherapy. However, the guidelines only specify 60 percent, so that this target is more than met. "We are very pleased that the targets that we have defined based on the guidelines have been achieved on average or even exceeded," explains the chairman of the DKG certification commission. In 13.5 percent of cases, however, there is a need for improvement.

Defects can also be identified based on the guidelines and target specifications, which the breast centers must then correct within three months to one year in order to maintain their quality seal. It depends on the severity of the shortcomings. In the event of serious defects, the quality seal can be withdrawn.

Self-help groups criticize early discharge and a lack of psychosocial care
However, the report also shows that there is still room for improvement. In the breast centers, for example, the provision of information is handled very differently. The involvement of patients in treatment can also be improved, reports the DKG. "From conversations with the patients, we know that there is often not enough time in the hospital for the informative discussion, especially when it comes to questions about psychosocial or psycho-oncological support," explains Karin Meißler, deputy chairwoman of women's self-help after cancer e.V.

Professor Holger Pfaff from the Institute of Medical Sociology at the University of Cologne reports: "There are, for example, clear differences between the individual centers." In the discharge of patients and the continuation of treatment in the doctor's office, improvements could still be achieved in some breast centers. Many patients are discharged from the clinic one day after the breast-conserving operation. The patients remain alone with their questions and do not receive adequate psychosocial care. (ag)

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