National Breast Cancer Audit

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The National Breast Cancer Audit is directed by the Breast Surgeons of Australia and New Zealand Inc. (BreastSurgANZ). All Full members of this society are required to participate in the audit.

Background
Access the NBCA Online Portal
Frequently Asked Questions 
Research projects and collaboration 
Publications 
Research summaries 
Downloads 
Contact

Background

Who we are

The National Breast Cancer Audit (NBCA) is a clinical audit developed with the aim of improving quality of care by surgeons for patients with early breast cancer in Australia and New Zealand. It was originally initiated as a pilot study in 1998 and has been running continuously now for over 10 years.

The database currently contains over 120,000 episodes of breast cancer, with over 250 surgeons contributing data each year from across Australian and New Zealand. A list of contributing members is available from BreastSurgANZ.

The NBCA provides surgeons with a self-audit tool to monitor their own surgical practice in relation to evidence based standards, as well as participating in a quality improvement cycle. The data is also used in a de-identified and aggregated form for research into breast cancer treatment in Australia and New Zealand. More information about this research can be found on our publications page.

Participating in the audit

The audit is provided free of charge to members of BreastSurgANZ. Non-member access to the NBCA Online Portal is also available for a fee; however, non-members are not considered participants of the NBCA. 

The NBCA Online Portal is a secure web-based system for:

  • entering and storing patient data
  • accessing summaries of individual breast cancer cases
  • assessing practice against key performance indicators
  • benchmarking against peers
  • exporting personal cases to Microsoft Excel for further analyses


Other benefits of participating in the NBCA include:

Governance and structure

As of late 2010, the audit has been directed and funded by the Breast Surgeons of Australia and New Zealand (BreastSurgANZ), a specialty society for surgeons treating breast cancer. Management of the audit continues to be provided through the Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S) in the Research, Audit and Academic Surgery Division of the College, with the office located in Adelaide, South Australia.

The audit has also been declared a Quality Assurance Activity under the Commonwealth Health Insurance (Quality Assurance Confidentiality) Amendment Act 1992 in Australia and has been declared a protected quality assurance activity under the Health Practitioner's Competence Assurance Act 2003 in New Zealand. The purpose of this legislation is to ensure that information that becomes available as a result of the activity can not be disclosed, other than for general reporting purposes (i.e. annual reports, research papers).

Research projects and collaborations

The NBCA dataset offers significant research opportunities. Articles are frequently published by the NBCA team in peer reviewed journals, details of which can be found on our publications page. Consumer friendly summaries of this research is available on our research summaries page.

The NBCA also collaborates with national agencies on research into breast cancer treatment, with the most recent summarised below.

Researchers can apply for access to de-identified data or tabulations through the NBCA Data Request process. Our Data Request Subcommittee will consider any request.

Factors that influence survival

The audit collaborated with Cancer Australia over several years to conduct research into factors that influence survival from breast cancer.

2010
With funding from the National Breast Cancer Foundation, NBCA data on Australian patients was successfully linked with the National Death Index.  Subsequent research examined the effects of age, surgeon caseload, treatment centre location and health insurance status.  A peer-reviewed article on the successful linkage has been published in the ANZ Journal of Surgery in November 2010.  Two peer-reviewed articles on the research findings are currently in press, awaiting publication.

2011
The project continued with further funding from the National Breast Cancer Foundation.  New Zealand data was included in the analyses for the first time, by linking with the New Zealand Cancer Registry data and Mortality data through the generous support of the Cancer Society of New Zealand .  Research focused on the effects of bilateral synchronous cancer and declining treatment.  Two peer-reviewed articles are currently being finalised.

2012
The proposed work for 2012 will involve further collaboration with Cancer Australia on several research topics that examine factors affecting survival from breast cancer.  As the NBCA has continued to collect data on breast cancer treatment since the previous linkage, it is also proposed that a new linkage with the NDI create a more up-to-date dataset for analysis. Topics that may be explored include mastectomy rates, cancer management by region, adherence to guidelines, immediate breast reconstruction and post-mastectomy radiotherapy, among other possibilities.

BreastScreen Aotearoa

The NBCA produced reports on New Zealand breast cancer treatment for cases diagnosed in 2008 (PDF 322 KB), 2009 (PDF 360 KB) 2010 (PDF 381 KB) and 2011 (PDF 314 KB). These reports were funded by the New Zealand Ministry of Health, through BreastScreen Aotearoa, and examined tumour characteristics and treatment of patients referred from BreastScreen Aotearoa compared with referrals via other means.

Downloads

Data collection forms

The forms below are provided as a resource for collecting data prior to input into the NBCA Online Portal.

The full dataset form includes all fields collected by the NBCA, both mandatory and optional, thus allowing the full research and record keeping potential of the audit to be utilised.
Full Dataset Form (PDF 92 KB, December 2013)
Follow Up Only Form (PDF 44 KB, January 2011)

Minimum dataset (MDS) forms provide a shorter alternative to the full dataset while including all data items necessary for threshold calculations on key performance indicators.
Invasive Cases MDS Form (PDF 56 KB, December 2013)
Ductal Carcinoma In Situ Cases MDS Form (PDF 44 KB, December 2013)

Patient information

All patients to be entered into the audit need to receive the following information sheet.
Patient information and opt-out consent (PDF 211 KB, March 2011)

Useful documents to aid data entry

Online Data Entry Manual (PDF 776 KB, December 2011)
Data Dictionary (PDF 568 KB, December 2013)
Instructions for updating incomplete episodes (PDF 37 KB, June 2010)

Data release

Data Release Policy (Word 53 KB, 2006)
Data Release Request Form (PDF 266 KB, August 2011)

Reports

Reports on NBCA progress
An excerpt from the ASERNIP-S Annual Report 2012 (PDF 236 KB)
An excerpt from the ASERNIP-S Annual Report 2011 (PDF 220 KB)
An excerpt from the ASERNIP-S Annual Report 2010 (PDF 116 KB)
An excerpt from the ASERNIP-S Annual Report 2009 (PDF 233 KB)
An excerpt from the ASERNIP-S Annual Report 2008 (PDF 166 KB)
National Breast Cancer Audit Progress Report -March 2006 (PDF 595 KB)
National Breast Cancer Audit progress report - May 2005 (PDF 547 KB)
Process for managing outliers in breast cancer surgery - March 2005 (PDF 233 KB)

Reports using NBCA data

BQA: Report on New Zealand episodes diagnosed in 2011 (PDF 314 KB)
NBCA: Report on New Zealand episodes diagnosed in 2010 (PDF 381 KB)
NBCA: Report on New Zealand episodes dignosed in 2009 (PDF 360 KB)
NBCA: Report on New Zealand episodes diagnosed in 2008 (PDF 322 KB)
National Breast Cancer Audit Public Health Monitoring Report 2008
(PDF 895 KB)
National Breast Cancer Audit Public Health Monitoring Report 2007 (PDF 351 KB)
National Breast Cancer Audit Public Health Monitoring Report 2006 (PDF 538 KB)
Report on threshold levels for 2006 data (members only; login required, PDF 476 KB)

Contact

The National Breast Cancer Audit is managed by the Morbidity Audits Department of the Research, Audit and Academic Surgery Division of the College.

For further information or assistance, contact the helpdesk:

National Breast Cancer Audit
Royal Australasian College of Surgeons
199 Ward Street
North Adelaide SA 5006 Australia

Telephone: +61 8 8219 0918
Fax: +61 8 8219 0999
Email: breast.audit@surgeons.org.