Indicators of the quality of breast cancer care pathways for women with or without severe mental illness

September 2023

Scope: Women treated for a pre-existing SMI and breast cancer (of a non-metastatic invasive type with or without lymph node involvement) incident in 2013 or 2014, matched (n=1,346) with three female controls who had no pre-existing SMI, and these controls.

Source: The National Health Data System (Système national des données de santé, SNDS)

Reading: A lesser average quality of treatment was observed amongst women with pre-existing SMI for all the indicators of quality of care, but statistically significant differences with their controls were only observed for indicators associated with the diagnosis and post-treatment follow-up. Hence, they were less likely to receive their first cancer treatment in an adequate timeframe after the recommended diagnosis tests, and to have a biopsy before the first treatment, even after taking into account the adjustment factors (clinical and socio-economic characteristics, and place of treatment).

*In the frame of the national definition of indicators of the quality of breast cancer care pathways, a target to attain and a level of alert were defined by the experts (Houzard et al., 2022). Target thresholds are higher (> or ≥) than the values shown on the graph, and alert thresholds are lower (< or ≤) than the values shown, except for the indicator on breast reintervention, for which these thresholds must be interpreted in the other direction.

Taken from Gandré C., Moreau D., Ben Dridi I. and Seppänen A-V. "Barriers, Levers, and Contrasts in Complex Care Pathways : the Case of Cancer amongst People Living with a Severe Mental llness", in collaboration with the Canopée Consortium, IRDES, Issues in Health Economics (281), September 2023.