Annals of Surgical Oncology

, Volume 26, Issue 5, pp 1202–1211 | Cite as

Impact of Breast Center Accreditation on Compliance with Breast Quality Performance Measures at Commission on Cancer-Accredited Centers

  • Megan E. Miller
  • Richard J. Bleicher
  • Cary S. Kaufman
  • Scott H. Kurtzman
  • Cecilia Chang
  • Chi-Hsiung Wang
  • Karen A. Pollitt
  • James Connolly
  • David P. Winchester
  • Katharine A. YaoEmail author
Health Services Research and Global Oncology



This study was designed to determine whether accreditation by the National Accreditation Program for Breast Centers (NAPBC) is associated with improved performance on six breast quality measures pertaining to adjuvant treatment, needle/core biopsy, and breast conservation therapy rates at Commission on Cancer (CoC) centers.


National Cancer Database 2015 data were retrospectively reviewed to compare patients treated at CoC centers with and without NAPBC accreditation for compliance on six breast cancer quality measures. Mixed effects modeling determined performance on the quality measures adjusting for patient, tumor, and facility factors.


Of 1308 CoC facilities, 484 (37%) were NAPBC-accredited and 111,547 patients (48%) were treated at NAPBC centers. More than 80% of patients treated at both NAPBC and non-NAPBC centers received care in compliance with breast quality measures. NAPBC centers achieved significantly higher performance on four of the five quality measures than non-NAPBC centers at the patient level and on five of six measures at the facility level. For two measures, needle/core biopsy before surgical treatment of breast cancer and breast conservation therapy rate of 50%, NAPBC centers were twice as likely as non-NAPBC centers to perform at the level expected by the CoC (respectively odds ratio [OR] 1.96, 95% confidence interval [CI] 1.85–2.08, p < 0.0001; and OR 2.05, 95% CI 1.94–2.15, p < 0.0001).


While NAPBC accreditation at CoC centers is associated with higher performance on breast quality measures, the majority of patients at all centers receive guideline-concordant care. Future studies will determine whether higher performance translates into improved oncologic and patient-reported outcomes.



The authors have no conflicts of interest to disclose.


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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Megan E. Miller
    • 1
    • 2
  • Richard J. Bleicher
    • 1
    • 3
  • Cary S. Kaufman
    • 1
    • 4
  • Scott H. Kurtzman
    • 1
    • 5
  • Cecilia Chang
    • 1
    • 6
  • Chi-Hsiung Wang
    • 1
    • 6
  • Karen A. Pollitt
    • 1
    • 7
  • James Connolly
    • 1
    • 8
  • David P. Winchester
    • 1
    • 9
  • Katharine A. Yao
    • 1
    • 6
    • 10
    Email author
  1. 1.The Data Working Group, National Accreditation Program for Breast CentersAmerican College of SurgeonsChicagoUSA
  2. 2.Department of Surgery, Case Western Reserve UniversityUniversity HospitalsClevelandUSA
  3. 3.Department of SurgeryFox Chase Cancer CenterPhiladelphiaUSA
  4. 4.Department of SurgeryBellingham Regional Breast CenterBellinghamUSA
  5. 5.Department of SurgeryUniversity of Connecticut Health CenterWaterburyUSA
  6. 6.Division of Bioinformatics, Research InstituteNorthShore University HealthSystemEvanstonUSA
  7. 7.Division of Research and Optimal Patient CareAmerican College of SurgeonsChicagoUSA
  8. 8.Department of PathologyBeth Israel Deaconess Medical CenterBostonUSA
  9. 9.Cancer ProgramsAmerican College of SurgeonsChicagoUSA
  10. 10.Division of Surgical Oncology, Department of SurgeryNorthShore University HealthSystemEvanstonUSA

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