AB228. SOH26AB_0388. Investigation of time to adjuvant chemotherapy initiation following breast cancer surgery—a key performance indicator audit at University Hospital Limerick
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AB228. SOH26AB_0388. Investigation of time to adjuvant chemotherapy initiation following breast cancer surgery—a key performance indicator audit at University Hospital Limerick

Chrisen Ramkaran1, Clara Forrest2, Juliette Buckley1, Shona Tormey1, Anne Merrigan1, Roshni Kalachand2, Chwanrow Baban1

1Department of Breast Surgery, University Hospital Limerick, Limerick, Ireland; 2Department of Medical Oncology, University Hospital Limerick, Limerick, Ireland

Background: The National Cancer Control Programme (NCCP) has stipulated several key performance indicators (KPIs) to assess the overall management of breast cancer in Ireland. One KPI, 5 days, requires that over 90% of patients must start adjuvant chemotherapy, if indicated, within 8 weeks of final breast cancer surgery. This audit aimed to investigate the time to adjuvant chemotherapy and identify areas for improvement.

Methods: Data from January 2019 to May 2025 were extracted from the Breast Cancer Database. This database is prospectively collected in the Breast Unit at University Hospital Limerick. Variables including demographic data, time to adjuvant chemotherapy initiation, and reasons for delay were recorded. Descriptive statistics, including mean time to chemotherapy initiation and percentage compliance, were conducted. Exploration of reasons for non-compliance was assessed and analysed to identify areas for improvement.

Results: During the study period, 39.1% (n=109/276) of breast cancer patients received adjuvant chemotherapy within 8 weeks of the final surgical procedure. Mean time to chemotherapy was 9 weeks. Reasons for non-compliance included the requirement of further investigations (22%, n=37), issues with wound healing (19%, n=32), and awaiting Oncotype Dx results (18%, n=31). A further 12.5% (n=21) of cases, related to other non-surgical or medical reasons, patient’s choice, capacity constraints, and receipt of referral delays.

Conclusions: Over a 6-year period, compliance with the NCCP’s KPI relating to initiation of adjuvant chemotherapy after breast cancer surgery within 8 weeks was 39.1%. This is below the recommended level of 90%. Multiple contributing factors have been highlighted by this audit and serve as potential areas of future improvement.

Keywords: Adjuvant chemotherapy; breast cancer; breast surgery; key performance indicator (KPI); quality improvement

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab228
Cite this abstract as: Ramkaran C, Forrest C, Buckley J, Tormey S, Merrigan A, Kalachand R, Baban C. AB228. SOH26AB_0388. Investigation of time to adjuvant chemotherapy initiation following breast cancer surgery—a key performance indicator audit at University Hospital Limerick. Mesentery Peritoneum 2026;10:AB228.

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