J Breast Cancer.  2010 Mar;13(1):96-103. 10.4048/jbc.2010.13.1.96.

Five-years of Breast Cancer Management in a New Hospital: Analysis Using Clinical Data Warehouse

• Kang E
• Han SA
• Kim S
• Kim SM
• Jang M
• Lee HE
• Park SY
• Lim JY
• Yang EJ
• Kim IA
• Kim YK
• Heo CY
• Kim YJ
• Kim JH
• Kim JH
• Kim SW

• KMID: 2286566
• DOI: http://doi.org/10.4048/jbc.2010.13.1.96

Abstract

PURPOSE
This study is to review the initial 5-years of breast cancer management in a single hospital using the clinical data warehouse (CDW).
METHODS
We reviewed the electronic medical records of 754 patients with breast cancer who were treated by a single surgeon between June 2003 and December 2007 in Seoul National University Bundang Hospital. We analyzed the epidemiological, clinical and therapeutic profiles of the breast cancer patients which were encoded and stored at the CDW.
RESULTS
The mean age of the patients was 49.3 years and the peak incidence was in the fifth decade (36.6%). Symptomatic breast cancer was 74.6% and screening-detected breast cancer was 25.4%. Breast conserving surgery (BCS) was performed in 54.1% of all cases and the BCS rate increased annually. Immediate reconstruction after mastectomy was performed in 62 cases (17.7%). Sentinel lymph node (SLN) biopsy for nodal staging was performed in 501 cases (72.1%) and 160 cases (23.0%) underwent complete axillary lymph node dissection. The proportion of in situ and early stage invasive breast cancer was 85.0%. Six hundred and ninety three patients (92.5%) received more than one adjuvant therapy. Thirty one patients experienced local or systemic relapse after surgery and ipsilateral breast tumor recurrence (IBTR) occurred in 6 cases. The median follow-up period was 29.5 months. Two-year and 3-year disease-free survival rates were 95.9% and 94.4%.
CONCLUSION
BCS and SLN biopsy continuously increased and immediate reconstruction after mastectomy was performed widely. Most patients received more than one adjuvant therapy. Moreover, we saved the time and human power to review the medical record by using the CDW.

Keyword

Breast neoplasm; Computerized medical records systems

MeSH Terms

Biopsy
Breast
Breast Neoplasms
Disease-Free Survival
Electronic Health Records
Follow-Up Studies
Humans
Incidence
Lymph Node Excision
Lymph Nodes
Mastectomy
Mastectomy, Segmental
Medical Records
Medical Records Systems, Computerized
Nitriles
Pyrethrins
Recurrence
Nitriles
Pyrethrins

Figure

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  Figure 1 The process of analysis using clinical data warehouse. Clinical data was stored in a data warehouse, and clinical information was analyzed out using data mining.

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  Figure 2 Items in clinical data warehouse. The various clinical information including first medical examination of patients and index of management of breast cancer were obtained through the clinical data warehouse.

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  Figure 3 Trends of operation methods. Breast conserving surgery (BCS) was performed 54.1% of all cases and the BCS rate increased annually.

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  Figure 4 Trends of operation for axillary staging. Sentinel lymph node biopsy increased annually and was performed in 192 cases (89.3%) in 2007. SLNB=sentinel lymph node biopsy; ALND=axillary lymph node dissection.

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  Figure 5 Overall disease-free survival. During 29.5 months of median follow-up, the 3-yr disease-free survival rate was 94.4%.

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  Figure 6 Analysis of immediate reconstruction rate using clinical data warehouse. The result of immediate reconstruction rate after mastectomy was reported easily by setting the condition for the period.

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