pISSN 1738-6756   eISSN 2092-9900
Open Access, Peer-reviewed
    J Breast Cancer. 2010 Mar;13(1):96-103. Korean.
    Published online Mar 31, 2010.
    https://doi.org/10.4048/jbc.2010.13.1.96
    Copyright © 2010 Korean Breast Cancer Society
    Original Article

    Five-years of Breast Cancer Management in a New Hospital: Analysis Using Clinical Data Warehouse

    Eunyoung Kang,1 Sang Ah Han,1 Sairhee Kim,1 Sun Mi Kim,1 Mijung Jang,1 Hee Eun Lee,1 So Yeon Park,1 Jae-Young Lim,1 Eun Joo Yang,1 In Ah Kim,1 Yu Kyeong Kim,1 Chan Yeong Heo,1 Yu Jung Kim,1 Jee-Hyun Kim,1 Jeong-Hyun Kim,1 and Sung-Won Kim1,2
      • 1Breast Care Center, Seoul National University Bundang Hospital, Seongnam, Korea.
      • 2Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
    • Corresponding author (Email: brcakorea@gmail.com )
    Received March 19, 2009; Accepted September 15, 2009.

    Abstract

    Purpose

    This study is to review the initial 5-years of breast cancer management in a single hospital using the clinical data warehouse (CDW).

    Methods

    We reviewed the electronic medical records of 754 patients with breast cancer who were treated by a single surgeon between June 2003 and December 2007 in Seoul National University Bundang Hospital. We analyzed the epidemiological, clinical and therapeutic profiles of the breast cancer patients which were encoded and stored at the CDW.

    Results

    The mean age of the patients was 49.3 years and the peak incidence was in the fifth decade (36.6%). Symptomatic breast cancer was 74.6% and screening-detected breast cancer was 25.4%. Breast conserving surgery (BCS) was performed in 54.1% of all cases and the BCS rate increased annually. Immediate reconstruction after mastectomy was performed in 62 cases (17.7%). Sentinel lymph node (SLN) biopsy for nodal staging was performed in 501 cases (72.1%) and 160 cases (23.0%) underwent complete axillary lymph node dissection. The proportion of in situ and early stage invasive breast cancer was 85.0%. Six hundred and ninety three patients (92.5%) received more than one adjuvant therapy. Thirty one patients experienced local or systemic relapse after surgery and ipsilateral breast tumor recurrence (IBTR) occurred in 6 cases. The median follow-up period was 29.5 months. Two-year and 3-year disease-free survival rates were 95.9% and 94.4%.

    Conclusion

    BCS and SLN biopsy continuously increased and immediate reconstruction after mastectomy was performed widely. Most patients received more than one adjuvant therapy. Moreover, we saved the time and human power to review the medical record by using the CDW.

    Keywords
    Breast neoplasm; Computerized medical records systems

    Figures

    Figure 1
    The process of analysis using clinical data warehouse. Clinical data was stored in a data warehouse, and clinical information was analyzed out using data mining.

    Figure 2
    Items in clinical data warehouse. The various clinical information including first medical examination of patients and index of management of breast cancer were obtained through the clinical data warehouse.

    Figure 3
    Trends of operation methods. Breast conserving surgery (BCS) was performed 54.1% of all cases and the BCS rate increased annually.

    Figure 4
    Trends of operation for axillary staging. Sentinel lymph node biopsy increased annually and was performed in 192 cases (89.3%) in 2007. SLNB=sentinel lymph node biopsy; ALND=axillary lymph node dissection.

    Figure 5
    Overall disease-free survival. During 29.5 months of median follow-up, the 3-yr disease-free survival rate was 94.4%.

    Figure 6
    Analysis of immediate reconstruction rate using clinical data warehouse. The result of immediate reconstruction rate after mastectomy was reported easily by setting the condition for the period.

    Tables

    Table 1
    Associated factors with breast cancer

    Table 2
    Patient characteristics

    Table 3
    HER2 status

    References

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    MeSH Terms
    Biopsy
    Breast
    Breast Neoplasms
    Disease-Free Survival
    Electronic Health Records
    Follow-Up Studies
    Humans
    Incidence
    Lymph Node Excision
    Lymph Nodes
    Mastectomy
    Mastectomy, Segmental
    Medical Records
    Medical Records Systems, Computerized
    Nitriles
    Pyrethrins
    Recurrence
    Metrics
    Share
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