Introduction and Rationale. Nilai Medical Centre was established on 1999 in Nilai Negeri Sembilan. In a partnership with Malaysian Health Travel Council data was collected prospectively using the HPMRS platform. HPMRS is a locally developed data base system to measure health care performance and reporting. For the purpose of measuring breast cancer performances, we mostly adopted the performances measures developed and used by Quality Oncology Practice Initiative, American Society of Clinical Oncology/National Comphressive Cancer Network and National Accreditation Program for Breast Cancer.
Data Data was reported to HPMRS by year of reporting according to the centre participating in MHTC’s PHTE program. A total of 226patients were reported from 2010 till 2014. 76 patients were ineligible for inclusion while 53 patients had incomplete data for analysis and were excluded from analysis.
The Aged ranged from 33 to 79 with a mean of 51years, 43% were aged <50years. 41% Chinese, 38% Malays and 20% Indians. 41% Early Breast Cancer, 35% Locally Advanced Cancer and 16% metastatic Breast Cancer. Receptor states were 55% positive for ER,43% PR and 31% for HER2. 19% had Triple negative breast cancer. Breast Cancer Care Performances The overall Breast Cancer care results was 98%. A 98% composite score means that the centre provided an evidence based Breast Cancer Treatment 98 times for ever 100 opportunities. Performances varied from as low as 50%(Trastuzumab treatment ) to a perfect score of 100% (Pathology report confirming malignancy, surgical treatment and radiotherapy) Survival Data The 5 years overall survival 99% Stage I, 83% Stage II,36% Stage III and 28% Stage IV. The relative survival at 5years was 99% Stage I and 97% Stage II indicating these patients were practically cured of their disease. This was far better then the results reported in Malaysian Study on Cancer survival of 87% in Stage I and 80% in Stage II. In the other stages NMC survival was 81.9% in Stage III and 50.4% in stage IV compared with 59% in Stage III and 23.3% in Stage IV in the Malaysia Study. NMC results were comparable with the SEER results( 2008 till 2014) as Early stage 99%,Localized Stage 85% and Distant stage 27%.
The results will set as a base line for future measurements.
Kananathan R.
Has not received any funding.
All authors have declared no conflicts of interest.