Last Update: 08/05/2012 14:44
Getting started
How can I get a new account?
Do I need to set up a new
account?
Can I change my login
details?
How do I add a Hospital to My Hospitals
List?
How do I start entering data
online?
What if I come across a computer
problem in the middle of data entry?
Is there an alternative
method of data entry?
Data entry
What if the value of my
data exceeds the permitted range allowed in a data field?
What if the type of breast cancer is
both an invasive breast cancer and DCIS?
If I use the Minimum Dataset option, what if
I want to include a field outside of this dataset?
Do I need to enter data for patients who
received no surgical treatment?
Do I need to enter data for advanced or
metastatic cases?
Do I enter data for lobular carcinoma in
situ (LCIS) or Paget's disease of the breast?
What do I enter if the receptor status
of the larger tumour is negative but the receptor status of a
smaller secondary tumour is positive?
Do I need to record two episodes for bilateral
cases?
Do I need to record two episodes for
multifocal/multicentric cases?
What do I do if the pathology report does
not specify tumour size?
What do I do if the pathology report does
not specify margin size?
How do I record margin size for
a case with a re-excision?
How do I record a case where
axillary surgery was performed but no lymph nodes were
identified?
A case is marked as incomplete with a
red cross. How can I complete it?
How do I record a recurrence?
How do I record data on the follow-up
appointment?
How do I record a patient who has had
neoadjuvant treatment?
How do I record a case with an unknown
primary?
How do I record microinvasion?
How do I enter details for a
patient who has yet to decide on adjuvant therapy?
Data access and reporting
How do I get a summary of my
data?
Can I have a brief summary of all my
procedures?
What if I want to access the group data from
my hospital or a group of surgeons?
Who else can access the data I
entered?
Support
How do I get the definition or
specification of each data field?
Where can I get more help for data
entry?
What do I do if I forget my log-in
details?
How can I contact NBCA staff?
Getting started
How can I get a new
account?
Contact the NBCA Help Desk on +61 8 8219 0918 or breast.audit@surgeons.org.
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Do I need to set up a new
account?
Only one account per surgeon is necessary. If you are
considering setting up a new account because you have moved to a
new hospital or you want to distinguish between your private and
public patients, it is not necessary to have a separate account as
you can select hospital and patient type during data entry.
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Can I change my login details?
You cannot change your user ID but you can change your password.
You can do this by selecting My User Details from the menu on the
left side of the screen. The following page will allow you to
re-enter a new password and confirm it in the next box.
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How do I add a
hospital to My Hospitals List
You can do this by selecting My Hospitals from the menu on the
left side of the screen. On this page you can add hospitals to your
personalised list. If necessary, you can click on the help button
on this page for further details or consult the NBCA Online Data Entry Manual (PDF 776 KB).
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How
do I start entering data online?
After you have logged into the system the first page you will
see is the summary page. Select My Breast Audit Patients to display
a list of all your patients entered on the database. From this page
you can add a new patient or episode and/or edit existing patients
and/or episodes.
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What if I
come across a computer problem in the middle of data entry?
To minimise data loss in the event of computer-related problems,
save your data promptly after entering it by clicking the save
button on the bottom of each data entry screen. If your data entry
is interrupted by a computer problem, restart the data entry
program and return to the last patient or episode you had entered;
then you can check or re-enter data if necessary.
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Is there an alternative
method of data entry?
If you have a small number of patients and/or have difficulty
entering data online, you can send us your data on a paper form.
This form can be downloaded from the main NBCA webpage. Please make sure you use the most
current paper data entry form. The form can then be posted or faxed
to the NBCA office.
Institutions with a compatible in-house database already recording
this information and a large number of eligible cases may be
suitable for our institutional uploads program. Please enquire
through our helpdesk at breast.audit@surgeons.org.
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Data entry
What if the value of my
data exceeds the permitted range allowed in a data field?
The data field ranges in the online system have been designed to
cover most situations and to improve the integrity of the data
collection. If you have data which exceeds a permitted range,
please check the original data to make sure that there has not been
a transcription error. If your data does exceed the permitted range
and you consider it should be allowed, please contact us as soon as
possible so we can determine whether changes need to be made with
the online data entry system.
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What if
the type of breast cancer is both an invasive breast cancer and
DCIS?
If the patient has both invasive and insitu components, mark it
as invasive and complete the appropriate pathology items, including
"total extent of lesion". The exception to this rule is if the case
involves microinvasion only. If an in situ case involves
microinvasion, mark the case as in situ and record the
microinvasion in the comments section of the full dataset.
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If I use the Minimum
Dataset option, what if I want to include a field outside of this
dataset?
The Minimum Dataset option includes only those items necessary
for a case to be considered complete. If you have entered all MDS
questions and would like to include further information, scroll
down to the bottom of the screen and click the button labelled
"Full Dataset". This will take you to the Full Dataset view and
allow you to answer further questions for record keeping or later
data analysis.
If you switch to the Full Dataset view, you do not have to answer
every question for the case to be considered complete. Cases
necessary for completeness are marked with an asterisk. The system
will also alert you on closing a case if you have missed any
mandatory completeness fields.
If the information you want to record is not specifically
included in the Full Dataset, you can add a note in the comments
section. Co-morbidities, for example, can be recorded here.
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Do I need to enter
data for patients who received no surgical treatment?
Yes, data from patients who received no surgical treatment for
any reason should be entered. If a patient does not have surgery,
please enter the case as a "no surgery" patient. This means ticking
the box labelled "no surgery" in the surgery section.
If no surgery was performed, mark all adjuvant treatment
questions as "no". Any therapy received must be recorded as
Neoadjuvant using the tick box under the relevant therapy.
If any question in the pathology section of the MDS is left
blank, the case will be labelled "incomplete" and will have a red
cross in the My Patients list. This is unavoidable for "no surgery"
cases and the red cross will need to be ignored for these
patients.
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Do I need to enter
data for advanced or metastatic cases?
No. The NBCA is an audit of early and locally advanced breast
cancer. Advanced or metastatic cases are not recorded.
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Do I enter
data for lobular carcinoma in situ (LCIS) or Paget's disease of the
breast?
If the patient presented with only LCIS or Paget's disease, do
not enter data into the audit. The NBCA does not collect
information on these conditions. If there was also an invasive or
ductal carcinoma in situ component, the patient can be entered.
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What do I
enter if the receptor status of the larger tumour is negative but
the receptor status of a smaller secondary tumour is positive?
Receptor status questions should be answered in reference to the
overall status of the patient so if the principal tumour in the
breast is negative but a second tumour is positive please record a
positive receptor status.
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Do I need to record two
episodes for bilateral cases?
Bilateral synchronous cases need to be recorded as two episodes.
Enter all Minimum Dataset (MDS) items for the first breast and save
and close the record. Then search for the patient and click "add an
episode". You will then need to enter the information for the other
breast.
If you are entering data in the MDS view, you will notice that
there is not an option to record laterality. You can still record
laterality by switching to "full dataset" view using the button at
the bottom of the screen. Laterality is recorded in the diagnosis
section.
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Do I need to
record two episodes for multifocal/multicentric cases?
Multifocal/multicentric cases are recorded as one episode.To
fill out the pathology section for a case with multiple tumours in
the same breast, record the most prognostically significant
information. For example, record the tumour size of the principal
tumour, record the distance to margin from the tumour which had the
closest margin, and record the receptor status as positive if any
of the tumours were positive.
The Full Dataset view includes a question which asks how many
invasive tumours in the breast (to switch from Minimum Dataset view
use the button at the bottom of the screen). Multifocal cases can
be categorised as multicentric for audit purposes. There is
currently no equivalent question for in situ cases. If you want to
record the number of in situ tumours, please use the comments field
located in the Full Dataset view.
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What do I do
if the pathology report does not specify tumour size?
If the pathology report does not specify tumour size, please
speak directly to the pathologist as this information is mandatory
for complete records.
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What do I do
if the pathology report does not specify margin size?
When entering your final assessment of relevant margins please
note that cases which do not record a precise figure for margin
(e.g. that record margin as "more than 10mm" or "clear") are not
considered as real integers and cannot be entered. We recommend you
request that your pathologist record precise margins if at all
possible.
If this is not possible, please record "10" for reports which
state "more than 10mm" and the code "99" for cases where the
pathologist has recorded "clear" which tells those analysing the
data that the margins were "clear" but a precise margin is
unknown.
Please note that only one margin size needs to be entered for the
case to be considered complete. If, for example, you have only the
vertical margin, enter that and leave the circumferential margin
questions blank.
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How do I record margin size for
a case with a re-excision?
If there is a re-excision, the width should be added to margin
clearance. In other words, if the original margin was clear (i.e.
more than 0) then you would need to add the distance to margin
measurements together.
The margins questions are seeking the distance from the invasive
(or DCIS) component to the closest margin, after completion of all
surgical procedures. For example, if the margin was clear after the
first excision (distance from tumour to margin was 1 mm) and a
re-excision was performed (a further 2mm shaved) then the distance
from the invasive tumour to the final margin would be the excision
margin plus the re-excision distance (3mm). The same is true if a
mastectomy was performed after an excision with clear margins.
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How do I record a case where
axillary surgery was performed but no lymph nodes were
identified?
If there is a case where axillary surgery is performed but no
lymph nodes are identified, enter zero nodes examined and zero
nodes positive with a note in the comments that no lymph nodes were
identified. This will allow for the completeness of the case.
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A case is
marked as incomplete with a red cross. How can I complete it?
The 'incomplete' crosses that appear on the patient list for
each surgeon act purely as a reminder to go back and add extra
information so that the entire Minimum Dataset is filled in. The
reason for labelling incomplete cases is so that all cases are as
complete as possible to ensure performance assessments are accurate
and data is complete enough for analysis.
To determine what is missing from an "incomplete" case, we
recommend opening the case in Minimum Dataset view. All fields in
this view should be answered. Alternatively, in Full Dataset view,
the fields marked with a blue asterisk are required for
completeness. When closing a case in either Full or Minimum view,
the system will alert users if the case remains incomplete and
provide a list of fields yet to be completed.
If a patient has surgery for the primary breast cancer, but no
axillary surgery, the case can be completed by inputting zero for
both nodes examined and nodes positive in the pathology section of
the dataset. This should also be done for cases where an axillary
dissection was performed but no lymph nodes were identified.
Only one margin size needs to be entered for the case to be
considered complete. That is, you do not need to enter both
Circumferential and Vertical margins, one of these will do. If, for
example, you have only the vertical margin, enter that and leave
the circumferential margin questions blank. If both margin sizes
are unknown please record the code "99" which tells those analysing
the data that the margins were "clear" but a precise margin is
unknown.
With the current constraints to the system, cases that have no
surgery will be marked incomplete. This is an issue with the way
"completeness" is calculated. Unfortunately, these patients
will remain marked as "incomplete" until the system is updated.
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How do I record a
recurrence?
If the recurrence occurs three months after an operation with
clear margins, this would be recorded as a new episode. Search for
the patient in your "my patients" list and click "add an episode".
If the recurrence occurs prior to three months, treatment would be
recorded on the original episode. Either way, the recurrence can be
recorded in the follow-up section of the Full Dataset view under
theoriginal episode for the patient.
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How do I record data on
the follow-up appointment?
To enter a follow-up: Search for the patient using the 'find'
boxes at the bottom of the 'my patients' list. Click on view/edit
episode. Click on edit this episode. If the case has opened in
Minimum Dataset view, scroll to the bottom of the screen and click
on the Full Dataset button. Click on the Follow-ups tab at the top
of the screen. Click on add. Enter details.
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How do I record a
patient who has had neoadjuvant treatment?
If a patient has had neoadjvant treatment, mark the neoadjuvant
tick box under the relevant treatment (e.g. chemotherapy,
radiotherapy). Please note that you still need to provide details
of whether they have had adjuvant treatment. Mark yes/no/referred
but not used under the relevant treatment option.
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How do I
record a case with an unknown primary?
Enter tumour size as zero.
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How do I record
microinvasion?
If an in situ case involves microinvasion, mark the case as in
situ and record the microinvasion in the comments section of the
full dataset.
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How do I enter details for a
patient who has yet to decide on adjuvant therapy?
The NBCA encourages users to enter data after all information is
known, however, there is the facility to enter what information is
known and come back and finish the case at a later date. A case can
be saved in the online system as long as all mandatory information
is entered (patient name, DOB, clinic reference, gender,
public/private status, postcode, treating hospital, and diagnosis
date). If a case is saved without adjuvant therapy information, the
case will be labelled as 'incomplete' and a red cross will appear
next to it in the patient list. This acts as a reminder that you
need to go back in and add some important information on this
case.
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Data access and reporting
How do I get a
summary of my data?
Selecting My Reports will allow you to get a summary of
your data in Microsoft Excel format. Click on the "Export my
data to Excel" button. This will download an Excel worksheet of all
episodes entered. If you are having trouble finding the data you
are looking for or performing analyses on this data, contact the
helpdesk for assistance: breast.audit@surgeons.org.
To get a printable summary of one particular patient record,
similar to the minimum dataset paper form, click the "episode
summary" button on the display episodes screen. This screen is
accessed by clicking view/edit episode(s) next to the patient
listed in the My Patients module of the online portal.
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Can I
have a brief summary of all my procedures?
Yes, by selecting My Breast Surgery Summary you can see a brief
summary of the number of procedures you have carried out on your
patients. The quality thresholds for several performance indicators
and your practice values are also available on the same webpage for
you to compare your personal data with the set level.
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What if I want to
access the group data from my hospital or a group of surgeons?
To obtain de-identified data that is not accessible under your
account, a formal request should be made using the NBCA Data Request Form (PDF 266 KB). The
request will be assessed by the Data Request Subcommittee based on
the Data Release Policy (Word 53 KB). If surgeon
identification is required, or if the subset is small enough that
identification may be possible, written permission is required
from each surgeon concerned.
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Who else can access
the data I entered?
The data collected from the Audit will only be used for the
stated objectives of the NBCA.
In Australia, the audit has been declared under Part 95 of the
Health Insurance Act 1973 to be a quality assurance activity. In New Zealand,
the audit has been declared a protected quality assurance activity under the
Health Practitioner's Competence Assurance Act 2003. For this
reason the identifiable individual information obtained through our
activity cannot be disclosed to another person, organisation or to
a court without your written consent.
For more information on who can request data from the NBCA, see our
Data Release Policy (Word 53 KB).
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Support
How do I get
the definition or specification of each data field?
All data fields have been defined and specified in the NBCA Data Dictionary (PDF 530 KB) which can be
accessed from the main NBCA webpage. Other useful information available
on this website includes our regular newsletter, the latest data
entry paper form and audit reports.
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Where
can I get more help for data entry?
Each data entry field has its own help icon which provides a
definition of the field when hovered over with the mouse. The Online Data Entry Manual (PDF 776 KB) and NBCA Data Dictionary (PDF 530 KB) are also
available for download. You can also contact the helpdesk and we will be glad to help.
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What do I do
if I forget my log-in details?
If you forget your log-in details, you can contact the helpdesk
for a reminder, however, these reminders can only be sent to the
email address on record for that participant. It is important,
therefore, to keep your contact details up to date. If you update
your details with the College, this will not be automatically
filtered down to the NBCA.
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How can I contact NBCA
staff?
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
We welcome your feedback on any aspect of the National Breast
Cancer Audit.