1. WALES BREAST CANCER CLINICAL AUDIT (WBCCA) MDT DATA FOR PATIENTS DIAGNOSED in 2009, 2010 and Llandudno General Hospital (BCUHB) MDT

2. WBCCA 2009, 2010 AND 2011 – Llandudno General Hospital
Data Completeness
See accompanying sheet for key and calculations
WBCCA 2009, 2010 AND 2011 – Llandudno General Hospital

3. Key Clinical Indicators (KCI)
The Cancer National Specialist Advisory Group (NSAG) has established clinical indicators that measure best practice in the management of cancer. These are reviewed annually and those for invasive breast cancer are listed below:
KCI1 Pre-operative diagnosis rate (%) in symptomatic breast cancer cases. (minimum: 90%, target 95%)
KCI2 % histologically node negative patients having 1-7 nodes removed (minimum: 90%, target 95%)
KCI3 % ER positive women who received adjuvant hormonal therapy (minimum: 90%, target 95%)
KCI4 % of node positive women (aged <=60 years) who received adjuvant chemotherapy (minimum: 80%, target 90%)
KCI5 % of patients who had breast conservation surgery for invasive breast cancer having breast radiotherapy. (minimum: 90%, target 100%)
WBCCA 2009, 2010 AND 2011 – Llandudno General Hospital

4. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
KCI 1 Proportion of invasive symptomatic cases with a pre-operative diagnosis (2011)
target
minimum
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

5. Primary treatment for invasive cancers (2011)
No. invasive cases
Primary surgical treatment
Non-surgical treatment
Unknown
BRONGLAIS GENERAL HOSPITAL 35 27 6 2
GLAN CLWYD CANCER SERVICES
120
105 13
LLANDUDNO GENERAL HOSPITAL
269
242
NEATH PORT TALBOT HOSPITAL
157
145 10
NEVILL HALL HOSPITAL 97 77 20
PRINCE CHARLES HOSPITAL 55 19 1
PRINCE PHILIP HOSPITAL
185
142 36 7
PRINCESS OF WALES HOSPITAL 25 5
ROYAL GLAMORGAN HOSPITAL
215
179 30
ROYAL GWENT HOSPITAL
211
161 47 3
SINGLETON HOSPITAL
240
205 34
LLANDOUGH HOSPITAL
309
264 39
WITHYBUSH GENERAL HOSPITAL 92 69 17
YSBYTY MAELOR WREXHAM
208
166 38 4
ALL WALES
2218
1824
349 45
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

6. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
Variation by hospital in mastectomy rates for all surgically treated invasive breast cancers (2011, all tumour sizes).
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

7. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
KCI 2: Variation in the number of nodes removed by hospital from women surgically treated for node negative invasive breast cancers (2011)
target
minimum
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

8. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
Variation in recording of axillary clearance in surgically treated women with histologically node-negative invasive breast cancer (2011)
Axillary clearance %
Total
BRONGLAIS GENERAL HOSPITAL 15
100.0%
GLAN CLWYD CANCER SERVICES 9
14.5% 62
LLANDUDNO GENERAL HOSPITAL 17
11.6%
146
NEATH PORT TALBOT HOSPITAL
12.7% 71
NEVILL HALL HOSPITAL 6
12.5% 48
PRINCE CHARLES HOSPITAL 4
22.2% 18
PRINCE PHILIP HOSPITAL
20.7% 87
PRINCESS OF WALES HOSPITAL
0.0% 1
ROYAL GLAMORGAN HOSPITAL 13
10.4%
125
ROYAL GWENT HOSPITAL 7
8.4% 83
SINGLETON HOSPITAL
4.3%
139
LLANDOUGH HOSPITAL
3.7%
161
WITHYBUSH GENERAL HOSPITAL
3.0% 33
YSBYTY MAELOR WREXHAM 11
10.6%
104
ALL WALES
122
11.2%
1093
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

9. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
Variation in clearance of margins by hospital for invasive breast cancers following final surgery by breast conservation ( )
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

10. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
KCI 5: Variation in radiotherapy given after conservative surgery for invasive breast cancers ( )
target
minimum
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

11. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
Variation by hospital in age of invasive breast cancers receiving no radiotherapy after conservative surgery ( )
DATA
<65 %
65+
BRONGLAIS GENERAL HOSPITAL
0.0% 4
50.0%
GLAN CLWYD CANCER SERVICES 16
16.7% 11
13.8%
LLANDUDNO GENERAL HOSPITAL 39
14.5% 18
10.2%
NEATH PORT TALBOT HOSPITAL 14
8.1% 7
7.1%
NEVILL HALL HOSPITAL 5
4.5%
7.3%
PRINCE CHARLES HOSPITAL 3
12.5%
PRINCE PHILIP HOSPITAL
10.7% 10
10.4%
PRINCESS OF WALES HOSPITAL
ROYAL GLAMORGAN HOSPITAL
5.9%
6.5%
ROYAL GWENT HOSPITAL 17
10.6%
SINGLETON HOSPITAL 19
7.2% 8
6.8%
LLANDOUGH HOSPITAL 12
4.0%
4.8%
WITHYBUSH GENERAL HOSPITAL
3.6%
19.0%
YSBYTY MAELOR WREXHAM 24
ALL WALES
186
8.6%
121
9.9%
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

12. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
KCI 3: patients with invasive ER positive breast cancer receiving adjuvant hormone therapy (2011)
target
minimum
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

13. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
KCI 4: Variation by hospital of node positive invasive cases, under 61 years of age, receiving chemotherapy following surgery ( )
target
minimum
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

14. WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital
Variation in ER and HER-2 negative breast cancers receiving chemotherapy (2011)
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital

15. Further information and feedback
Full report on Cancer NSAG website
DN: add link
For audit queries and feedback contact clinical leads, information leads, analysts or cancer NSAG colorectal group representatives via
For Network resources to help improve outcomes contact:
SOUTH WALES CANCER NETWORK (SWCN)
NORTH WALES CANCER NETWORK (NWCN)
Cancer NSAG Breast group
Dr Kate Gower Thomas
(Chair) Radiologist
Dr Peter Barrett-Lee
(Deputy Chair) Clinical Oncologist
Prof Robert Mansel
Surgeon
Mr Ian Monypenny
Mr Rhodri Williams
Dr Andy Gash
Radiologist
Dr Nick Dallimore
Histopathologist
Rosemary Fox
Deputy Director of Screening
Dr Gianfilippo Bertelli
Medical Oncologist
Sue Brady
Nurse
Mr Walid Samra
NWCN Tumour Site Lead
Mr Simon Holt
SWCN Tumour Site Lead
Dr Jacinta Abraham
SWCN Tumour Site Deputy
WBCCA 2009, 2010 AND 2011 –Llandudno General Hospital