Background Breast cancer is one of the leading causes of cancer-related death. Current evidence suggests a gap between what is understood to be standard breast cancer management and what happens in clinical practice. The development and implementation of breast quality indicators (QIs) for breast cancer management is one way to achieve better care. This systematic review aimed to identify QIs developed for the management of breast cancer and to summarize characteristics and range of measures uncovered. Methods Studies related to the development of QIs for management and monitoring of breast cancer care were systematically searched, extracted and reviewed using four electronic databases (MEDLINE, EMBASE, CINAHL and Cochrane Library) following a Prospero Protocol Registration (CRD42020207945). The study was reported using the Preferred Reporting Items for the Systematic Review and Meta-analysis (PRISMA). This review reported on the development of QIs in the management of breast cancer and Donabedian’s framework was adopted as the analytical framework. Results Out of 1161 potentially relevant articles identified, eight studies met the inclusion criteria and were directly concerned with QI development for breast cancer care. These included two papers from China and one each from; The Netherlands, Belgium, Scotland and Canada. The remaining two were a collaboration among the European Society of Breast cancer Specialists (EUSOMA). The methods used by these studies to identify and develop QIs included a comprehensive literature review, medical records review, clinical guidelines, and Delphi consensus using an expert panel discussion. A total of 38 QIs were identified and classified as: structure (n = 3); process (n = 30); and outcome (n = 5). Structure indicators included: the availability of Multi-Disciplinary Team Meeting (MDT), medical records and breast cancer research infrastructure. Process indicators included eight diagnostic QIs, 22 treatment QIs and seven follow-up QIs. The outcome indicator focused mainly on the overall five-year survival statistics. Conclusions The development of QIs appears relevant to monitor clinical management and performance but is currently limited to higher income countries. Development and implementation of QIs in LMICs countries will improve practice.
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