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BQA performance indicators

Participating in the BreastSurgANZ Quality Audit (BQA) provides many benefits, including the ability for audit participants to check their performance against evidence-based performance indicators.

Key Performance Indicators (KPIs)

These indicators are evidence-based and have been determined through extensive examination and discussion by audit governance, as well as consultation with other experts and stakeholders in the field of breast cancer treatment.

Audit participants can check their performance against these indicators at any time through the online portal. The practice value for each indicator is based on cases diagnosed between 2018 and the present day.

KPI Description  Quality threshold 
BCS referred for RT Percentage of invasive cases undergoing breast conserving surgery referred for radiotherapy 85% or more
ER+ for hormone therapy Percentage of oestrogen positive invasive cases referred for hormonal therapy 85% or more
Axillary surgery Percentage of invasive cases undergoing axillary surgery 90% or more
Node negative axillary clearance Percentage of axillary clearance cases with zero positive nodes entered 5% or less
High risk with Mx for RT Percentage of high-risk invasive cases undergoing mastectomy referred for radiotherapy 85% or more
High risk for CT Percentage of high-risk cases referred for chemotherapy 90% or more
Use of Breast Nurse Percentage of cases with involvement of a breast care nurse in management of the patient 90% or more 
Participation in MDT Percentage of cases with discussion at a multidisciplinary meeting  90% or more 
TN and HER2+ for NACT Percentage of Triple Negative or HER2+ cases undergoing neoadjuvant chemotherapy, for patients <70 years old and tumour size ≥20mm 70% or more
Immediate reconstruction (DCIS) Percentage of in situ cases undergoing mastectomy receiving immediate reconstruction N/A
Immediate reconstruction (invasive) Percentage of invasive cases undergoing mastectomy receiving immediate reconstruction  N/A 
BCS in T1 Percentage of cases with breast conservation for invasive T1 (<20mm)  N/A 
Time to surgery Percentage of cases proceeding to surgery within 45 days of histological diagnosis, e.g. date of core biopsy  N/A 

High risk definitions

High risk with Mx for RT: Invasive tumours of at least 50mm or with at least four positive lymph nodes

High risk for CT: Invasive tumours that fall into any of the following categories:

  • Age less than 55 and Grade more than one and Tumour size more than two centimetres
  • Age less than 55 and Grade more than one and Tumour size not more than two centimetres and Nodes involved
  • Age not more than 70 and Tumour Her2 Positive and Tumour size more than five millimetres
  • Age not more than 70 and Receptors Triple Negative and Tumour size more than five millimetres.