The relationship between quality and cost during the perioperative breast cancer episode of care.

The relationship between quality and cost of care for breast cancer surgery was investigated by literature review. The guidelines, policy statements, quality measures (QM) and target goals for performance described by professional organizations were also reviewed. After review, the relationship between quality and cost of care for the components of perioperative care were assigned an inverse, direct or uncertain relationship. Identification of processes of care with an inverse relationship between quality and cost, such as performing a needle biopsy to diagnose cancer compared to an open surgical biopsy, provide opportunity to concurrently lower cost and improve quality. Other components of care, such as post-mastectomy reconstruction, demonstrate a direct relationship between quality and cost. Recognition of the variability of performance of QM's with an inverse quality and cost relationship has the potential to lower breast cancer population healthcare expenditures, if average performance for those QM can be improved.