A BREAST-CANCER CARE REPORT CARD - AN ASSESSMENT OF PERFORMANCE AND APURSUIT OF VALUE

The transition to managed care raises concerns about the resulting qua lity of care. The report card, a publicly released, standardized repor t on quality, has received widespread acceptance as a method to evalua te physician performance. Current report cards provide insufficient in formation to allow purchasers of health care to assess accurately the performance of professionals who provide breast care. To overcome thes e limitations, we propose an expanded report card on breast cancer car e. Mammographers and general surgeons would assess an independent seri es of at least 100 consecutive cases of newly diagnosed breast cancer. Mammographers would determine the percentage of invasive cancers <15 mm detected on screening mammograms in asymptomatic women aged 50 to 7 4 years. Surgeons would determine the percentage of combined stages 0 and I breast cancers detected and the percentage of patients receiving breast-conserving surgical therapy. Performance targets are set at 60 % for invasive cancers <15 mm detected on screening mammography, 60% f or combined stage 0 and I breast cancers, and 50% for patients receivi ng breast-conserving therapy.