Maes-Carballo, MartaGómez-Fandiño, YolandaReinoso-Hermida, AylaEstrada-López, Carlos RobertoMartín-Díaz, ManuelKhan, Khalid SaeedBueno-Cavanillas, Aurora2022-09-122022-09-122021-07-02Maes-Carballo M, Gómez-Fandiño Y, Reinoso-Hermida A, Estrada-López CR, Martín-Díaz M, Khan KS, et al. Quality indicators for breast cancer care: A systematic review. Breast. 2021 Oct;59:221-231.http://hdl.handle.net/10668/4036Objectives We evaluated breast cancer (BC) care quality indicators (QIs) in clinical pathways and integrated health care processes. Methods Following protocol registration (Prospero no: CRD42021228867), relevant documents were identified, without language restrictions, through a systematic search of bibliographic databases (EMBASE, Scopus, Web of Science, MEDLINE), health care valuable representatives and the World Wide Web in April 2021. Data concerning QIs, measurement tools and compliance standards were extracted from European and North American sources in duplicate with 98% reviewer agreement. Results There were 89 QIs found from 22 selected documents (QI per document mean 13.5 with standard deviation 11.9). The Belgian (38 QIs) and the EUSOMA (European Society of Breast Cancer Specialists) (34 QIs) documents were the ones that best reported the QIs. No identical QI was identified in all the documents analysed. There were 67/89 QIs covering processes (75.3%) and 11/89 (12.4%) for each structure and outcomes QIs. There were 21/89 QIs for diagnosis (30.3%), 43/89 for treatment (48.3%), and 19/89 for staging, counselling, follow-up and rehabilitation (21.4%). Of 67 process QIs and 11 outcome QIs, 20/78 (26%) did not report a minimum standard of care. Shared decision making was only included as a QI in the Italian document. Conclusion More than half of countries have not established a national clinical pathway or integrated breast cancer care process to achieve the excellence of BC care. There was heterogeneity in QIs for the evaluation of BC care quality. Over two-thirds of the clinical pathways and integrated health care processes did not provide a minimum auditable standard of care for compliance, leaving open the definition of best practice. There is a need for harmonisation of BC care QIs.enAttribution-NonCommercial-NoDerivatives 4.0 InternacionalAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Breast cancer careQuality indicatorsQuality careHealth careNeoplasias de la mamaIndicadores de calidad de la atención de saludCalidad de la atención de SaludAtención a la saludMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Delivery of Health CareMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health CareMedical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Breast NeoplasmsMedical Subject Headings::Health Care::Health Services Administration::Quality of Health Care::Quality Indicators, Health CareMedical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Critical PathwaysMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Standard of CareMedical Subject Headings::Geographical Locations::Geographic Locations::Europe::BelgiumMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up StudiesMedical Subject Headings::Information Science::Information Science::Medical Informatics::Medical Informatics Applications::Information Systems::Databases as Topic::Databases, Bibliographic::PubMed::MEDLINEMedical Subject Headings::Geographical Locations::Geographic Locations::Americas::North AmericaMedical Subject Headings::Information Science::Information Science::Computing Methodologies::Computer Systems::Computer Communication Networks::InternetMedical Subject Headings::Psychiatry and Psychology::Behavioral Disciplines and Activities::Mental Health Services::CounselingMedical Subject Headings::Geographical Locations::Geographic Locations::Europe::ItalyMedical Subject Headings::Information Science::Information Science::Communications Media::Publications::Bibliography as Topic::Bibliometricsreview article34298301open access10.1016/j.breast.2021.06.0131532-3080PMC8322135