Impact of quality control indicator system management program on neoadjuvant and adjuvant therapies for breast cancer: a comparative analysis

Background: Breast cancer (BC) management in China faces significant challenges, particularly in terms of standardizing diagnosis and treatment protocols across various healthcare settings. The implementation of a quality control (QC) indicator system offers a potential solution to improve treatment consistency and outcomes. This study evaluated the impact of a QC indicator system on the standardization of neoadjuvant and adjuvant therapies for BC. Methods: A QC system was developed by an expert panel in alignment with China's 2022 guidelines. A comparative study was conducted between Jiangsu Cancer Hospital (experimental, implementing PDCA-cycle management) and Nantong Tumor Hospital (control, routine practices). Key indicators included cTNM staging completeness, chemotherapy record standardization, and rational anti-tumor drug use. Additionally, clinical outcomes, patient-reported outcomes (PROs), and treatment adherence were assessed, alongside qualitative data derived from clinical records. Results: After the QC system was implemented, Jiangsu Cancer Hospital demonstrated significant improvements: cTNM staging completeness increased from 92.5% to 98.08%, chemotherapy record standardization improved by 66.65%, and rational drug use rose from 78% to 87.5% (all P