Annelotte van Bommel

29 The NABON Breast Cancer Audit Radiology. A final Breast Imaging-Reporting and Data System (BI-RADS) classification was used in breast imaging reports in 98% of the patients (97% in 2011 and 99% in 2014; see Table 2 ). Over the years 2011–2014, the percentage of patients who underwent breast MRI increased (from 83% to 89% before neo- adjuvant treatment and from28% to 31%before upfront surgery). The use of breast MRI varied largely between hospitals both for patients undergoing primary surgery (2014: range 4–84%; Figure 1 ) as well as for patients treated with neo-adjuvant systemic treatment (2014: range 0–100%). Figure 1. Funnel plot of variation between hospitals in the percentage of patients with invasive M0 breast cancer or ductal carcinoma in situ (DCIS) having a Magnetic Resonance Imaging (MRI)- scan prior to surgery in 2014. The 95% confidence intervals are displayed around the mean (31%). Pathology. The proportion of patients with complete pathology reports increased significantly over the years. In 2014, 97% of the pathology reports contained all required pathology items ( Table 2 ), and nearly every hospital (90 out of 92) reached the norm of 90% for this indicator compared to 66% of the hospitals reaching this norm in 2011. Percentage of patients with MRI-scan prior to surgery Hospital volume (2014) Hospital Mean 95% Cl 0 50 100 150 200 250 300 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2