Annelotte van Bommel

30 Surgery and reconstructive surgery. Fifty-nine percent and 68% of the patients underwent breast conserving therapy for invasive breast cancer and DCIS, respectively ( Table 1 ). The percentage of patients with tumor involved resection margins requiring re-operation after initial breast conserving surgery for invasive breast cancer was stable over the years: ~5% ( Figure 2 ). After neo-adjuvant chemotherapy, this percentagewas higher (7%) and highest for patients undergoing breast conserving surgery for DCIS (20%). All hospitals had results significantly below the predefined normof 15% for invasive breast cancer and 30% for DCIS. Figure 2 . Funnel plot of variation between hospitals in the percentage of patients with invasive breast cancer andmore than focal tumor-positivemargins after breast conserving surgery without neo-ad- juvant treatment (2014). The 95% confidence intervals are displayed around the standard (15%). An immediate breast reconstruction was performed in 17% (range 0–66%) of patients with invasive cancer and in 43% (range 0–84%) of patients diagnosed with DCIS who underwent a mastectomy. The percentage of patients receiving an immediate breast reconstruction increased over the years with a 50% relative Percentage of patients with tumor positive margins after breast conserving surgery without neo-adjuvant treatment Hospital volume (2014) Hospital Standard 95% Cl 0 20 40 60 80 100 120 140 160 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%