Standardized evaluation of regional and institutional breast cancer outcomes.

Background: Optimal breast cancer control outcomes include early diagnosis, thorough staging work-up, and lowest disease-related mortality.

Methods: The standardized case-mix index (SCI) for breast cancer was derived from the stage distribution of cases weighted for earlier diagnosis using the national stage 5-year mortality provided in the National Cancer Data Base expressed as an institution or region (observed) to national (expected) ratio (O/E). The standardized work-up index was the mean O/E mortality ratio for each stage.