American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Standard 2.6: Breast Cancer Staging

The Breast Program Leadership Committee (BPLC) develops a process to monitor physician use of American Joint Committee on Cancer (AJCC) staging in treatment planning for breast cancer patients.

Definition and Requirements

Accurate clinical and pathologic staging of breast cancer patients enables the physician to determine appropriate treatment. Staging facilitates the reliable evaluation of treatment results and outcomes reported to various institutions on a local, regional, and national basis. AJCC staging is assigned using the criteria outlined in the current edition of the AJCC Cancer Staging Manual.

All staging classifications—and, most importantly, clinical and pathological classifications—are documented in the medical record.

All physician members of the Breast Care Team (BCT) use clinical TNM and identify the stage grouping prior to making treatment decisions.

The BPLC develops a process for use of AJCC staging in defining treatment for breast cancer patients.

Process Requirements

Accession List and Data Review Requirements for the Site Visit

The center is required to provide a de-identified accession (case) list of breast cancer cases diagnosed and/or treated at the center (class of case 10–22) prior to the site visit date. Class of case is defined in the Facility Oncology Registry Data Standards (FORDS) manual.

The BPLC develops and reviews the use of the AJCC staging process and discusses the results of the review with the BCT.

Compliance is reviewed annually by the BPLC.

Documentation

Complete all required standard fields in the Survey Application Record (SAR).

Describe or upload the AJCC staging process for breast cancer patient treatment.

Document the BCT discussion of the staging process review, and the annual audit by the BPLC, in the meeting minutes.

Evaluation

The surveyor will review the staging process, and patient medical records during the medical records review portion of the site visit, to confirm the use of AJCC staging in treatment planning for breast cancer patients.

Rating Compliance

Compliance

  1. The BPLC develops a process to monitor physician use of AJCC staging in treatment planning for breast cancer patients.
  2. The BPLC reviews the use of the AJCC staging process and discusses the results of the review with the BCT.
  3. Compliance is reviewed annually by the BPLC and documented in the meeting minutes.

Noncompliance

The center does not fulfill one or more of the compliance criteria.

Resources

American Joint Committee on Cancer