Publication: Türkiye'deki üniversite hastanelerinde meme kanseri tanı ve cerrahi tedavisindeki uygulama farklılıkları
Abstract
Amaç: Bu çalışmada Türkiyede tıp fakültesi hastanelerinde meme kanseri cerrahi tedavisi ile ilgili sorunların belirlenmesi ve tanı / tedavi kalitesini artırmanın yollarının araştırılması amaçlanmıştır. Hastalar ve Yöntem: Yedi coğrafi bölgede 3. basamak merkez olarak belirlenen üniversite hastanelerinde meme kanseri tedavisi konsepti ve kaynakları ile bu merkezlerde 2009 yılında ameliyat edilen meme kanseri hastalarına uygulanan yaklaşımları sorgulayan bir anket hazırlandı. Ankete yanıt veren merkezlerin verileri değerlendirildi. Bulgular: Çalışmaya katılan 42 merkezde 2009 yılında ameliyat edilen 4982 hastanın verileri çalışma için değerlendirildi. Marmara bölgesi hariç diğer bölgelerde en sık kullanılan tanı yöntemi eksizyonel biyopsi idi. Tanı anındaki evre ile ilgili olarak Türkiyede bölgeler arasında büyük farklılıklar saptandı. Meme koruyucu cerrahi Güneydoğu Anadolu ve Akdeniz Bölgeleri dışında erken evre meme kanserinde en çok uygulanan ameliyat tipi idi. Yirmialtı (%62) merkezin mültidisipliner takım çalışması ile tanı ve tedavi uyguladığı saptandı. Sonuç: Bu çalışma ile ülkemizde meme kanseri hastalarının tanı ve tedavisinde bir homojenite olmadığı, coğrafi bölgelere göre uygulama farklılıkları olduğu görülmüştür. Uluslararası kurumlarca ortaya konan standartların hala ülkemizde yaygın olarak uygulanmadığı saptanmıştır. Altyapı yetersizliği ve tanı / tedavide multidisipliner değerlendirmenin olmaması en önemli eksiklikler olarak görülmüştür.
Purpose: In this study we aimed to determine the practice patterns on both diagnosis and treatment of breast cancer patients at university hospitals in Turkey. Patients and Methods: A questionnaire which asks the demographics and clinical findings of patients as well as infrastructure of hospitals and patterns of breast cancer treatment was prepared and sent to general surgeons who practice in university hospitals. Data were collected retrospectively and no comparison was done among institutions. Descriptive results were given. Results: Data from 42 hospitals and 4982 breast cancer patients who were operated in 2009 were assessed. Excisional biopsy were the most common tissue diagnostic procedure in all regions except Marmara region. Breast conserving surgery was the most preferred surgical method for early breast cancer in all over Turkey except South-Eastern and Mediterranean regions. Multidisciplinary team work was performed in 26 institutions. Conclusion: This study showed that there are wide differences in means of breast cancer diagnosis and treatment in different geographic regions in Turkey, therefore no homogeneity in breast health service at those hospitals which answered the questionnaire. It seems that there is still need to implement internationally agreed consensus quality measures in practice. Lack of infrastructure and multidisciplinary team work were the main problems on improving quality of breast care in Turkey.
Purpose: In this study we aimed to determine the practice patterns on both diagnosis and treatment of breast cancer patients at university hospitals in Turkey. Patients and Methods: A questionnaire which asks the demographics and clinical findings of patients as well as infrastructure of hospitals and patterns of breast cancer treatment was prepared and sent to general surgeons who practice in university hospitals. Data were collected retrospectively and no comparison was done among institutions. Descriptive results were given. Results: Data from 42 hospitals and 4982 breast cancer patients who were operated in 2009 were assessed. Excisional biopsy were the most common tissue diagnostic procedure in all regions except Marmara region. Breast conserving surgery was the most preferred surgical method for early breast cancer in all over Turkey except South-Eastern and Mediterranean regions. Multidisciplinary team work was performed in 26 institutions. Conclusion: This study showed that there are wide differences in means of breast cancer diagnosis and treatment in different geographic regions in Turkey, therefore no homogeneity in breast health service at those hospitals which answered the questionnaire. It seems that there is still need to implement internationally agreed consensus quality measures in practice. Lack of infrastructure and multidisciplinary team work were the main problems on improving quality of breast care in Turkey.