gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

Impact of quality assurance in breast cancer diagnosis on incidence and tumour stage distribution

Meeting Abstract

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  • corresponding author presenting/speaker Alexander Katalinic - Institut für Krebsepidemiologie an der Universität Lübeck, Lübeck, Deutschland
  • Carmen Bartel - Institut für Krebsepidemiologie an der Universität Lübeck, Lübeck
  • Ingrid Schreer - Mammazentrum am Universitätsklinikum Schleswig-Holstein, Kiel

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP514

The electronic version of this article is the complete one and can be found online at:

Published: March 20, 2006

© 2006 Katalinic et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction: While mammography screening is well evaluated, there is only little information about the quality of routine breast cancer diagnosis including mammography. In the state of Schleswig-Holstein (SH) a multidisciplinary quality assurance programme (QuaMaDi) was established involving gynaecologists, radiologists and a breast centre. Our abstract addresses the impact of this programme on incidence and tumour stage.

Methods: The QuaMaDi project is running since May 2001 in a pilot region inside SH. 75,000 examinations were documented until 2004. Breast cancer cases are recorded for the whole area of SH by the local cancer registry with a completeness of over 95%. The epidemiologic data of the cancer registry will be compared between the pilot region (300,000 female inhabitants) and the rest of SH. Age-standardized incidence rates (world standard) and stage distribution according to the TNM will be used. Additionally the stage distribution of the breast cancer cases detected by QuaMaDi is shown.

Results: 11,525 breast cancer cases occurred in SH from 1999 until 2003, 3201 (28%) of them in the pilot region. Age-standardized breast cancer incidence in the pilot region increased by 7.5% after the start of the project (1999-2000: 91.7/100,000; 2001-2003: 98.5/100,000). In the remaining country the incidence was stable for invasive breast cancer (1999-2000: 85.1/100,000; 2001-2003: 86.3/100,000), as well as for the in situ incidence (4.5/100,000). In the pilot region a increase of 100% of the ‘in situ’ incidence was observed (1999-2000: 5.2/100,000; 2001-2003: 10.6/100,000). Comparing the two regions a favourable tumour stage distribution was found for the pilot region (‘in situ’ and T1: 59.0% vs. SH without QuaMaDi: 49.7%). Patients detected by the QuaMaDi project had even higher proportion of ‘in situ’ and T1 tumours (68.8%).

Discussion: The pilot project QuaMaDi shows a significant impact on tumour stage distribution, not only within the group of the participating patients, but also on the population base. Although QuaMaDi is no screening project, effects comparable to screening programmes are observed (rising incidence, smaller tumours). Even if not all breast cancer cases in the pilot region were detected by QuaMaDi, the total quality of breast cancer diagnosis has improved, leading to higher detection rates and a better tumour stage distribution.