Breast Cancer Clinical Quality Performance Indicators Engagement Document.

Document explaining the process of, and inviting engagement on, revision of the breast cancer QPIs.

Appendix 6: Glossary of Terms

23-hour surgery 23-hour surgery is the admission of patients to hospital for a planned surgical procedure where they return home within
24 hours, i.e. involves 1 overnight stay.
Adjuvant therapy / treatment Treatment given in addition to the primary therapy, or a secondary remedy assisting the action of another.
Age-standardised Age-standardisation facilitates comparisons across geographical areas by controlling for differences in the age structure of local populations.
Axilla The armpit.
Axillary clearance Operation to remove all the lymph glands from under the arm.
Biopsy Removal of a sample of tissue from the body to assist in diagnosis of a disease.
Breast Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
Cause-specific survival A method of estimating net survival. Only deaths attributable to the cancer of diagnosis are counted as deaths, giving the probability of survival in the absence of other causes of death.
Chemotherapy The use of drugs that kill cancer cells, or prevent or slow their growth.
Co-morbidity The condition of having two or more diseases at the same time.
Conservation surgery An operation to remove the breast cancer but not the breast itself. Types of breast-conserving surgery include lumpectomy (removal of the lump), quadrantectomy (removal of one quarter, or quadrant, of the breast), and segmental mastectomy (removal of the cancer as well as some of the breast tissue around the tumour and the lining over the chest muscles below the tumour).
Core biopsy Removal (using a needle) of a piece of a breast tissue for diagnosis.
Day case Day surgery is the admission of selected patients to hospital for a planned surgical procedure, returning home on the same day.
Definitive procedure/ treatment The treatment plan for a disease or disorder that has been chosen as the best one for a patient after all other choices have been considered.
Deprivation Currently, the Scottish Index of Multiple Deprivation ( SIMD) is used to estimate an individual's level of affluence. This is based on seven domains (income, employment, education, housing, health, crime, and geographical access) combined into an overall index.
Ductal Carcinoma In Situ ( DCIS) When the breast cancer cells are completely contained within the ducts (the channels in the breast that carry milk to the nipple) and have not spread into the surrounding breast tissue.
Excision Margins The edge or border of the tissue removed in surgery.
Fine Needle Aspiration ( FNA) The withdrawal of fluid, containing cells, from the body by means of suction using a fine needle. The samples obtained are used to provide information on the cells of tumours or cysts.
Fluorescence In Situ Hybridization ( FISH) This is a lab test that measures the amount of a certain gene in cells. It can be used to see if an invasive cancer has too many HER2 genes.
Genetic Inherited; having to do with information that is passed from parents to offspring through genes in sperm and egg cells.
Histological / Histopathogical The study of the structure, composition and function of tissues under the microscope, and their abnormalities.
Hormonal therapy Treating a disease with hormones, or by blocking the action of hormones.
Human Epidermal growth factor Receptor ( HER) 2 One of many receptors on the surface of certain cells which can protect the cell from damage or stimulate it to grow. This is the target, present on some breast cancer cells, which is hit by Herceptin (trastuzumab).
Immediate Breast Reconstruction Breast reconstruction carried out at the same time as the operation to remove the breast.
Immunohistochemistry ( IHC) A technique used to identify specific molecules in different kinds of tissue. The tissue is treated with antibodies that bind the specific molecule. These are made visible under a microscope by using a colour reaction, a radioisotope, colloidal gold, or a fluorescent dye. Immunohistochemistry is used to help diagnose diseases, such as cancer, and to detect the presence of micro organisms. It is also used in basic research to understand how cells grow and differentiate (become more specialized).
In situ A cancer that is 'in place', is non-invasive, has not spread beyond the initial location.
Invasive Cancer that can or has spread from its histological original site.
Kaplan Meier A widely used technique for estimating observed (crude) survival.
Lesion Tumour, mass, or other abnormality.
Lobular Carcinoma In Situ ( LCIS) A condition in which abnormal cells are found in the lobules of the breast. Lobular carcinoma in situ seldom becomes invasive cancer; however, having it in one breast increases the risk of developing breast cancer in either breast.
Lymph Nodes Small bean shaped organs located along the lymphatic system. Nodes filter bacteria or cancer cells that might travel through the lymphatic system.
Malignant/Malignancy Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body.
Mastectomy Surgical removal of a breast.
Metastases/Metastatic Spread of cancer away from the primary site to somewhere else via the bloodstream or the lymphatic system.
Morbidity How much ill health a particular condition causes.
Morphology / Morphologically The science of the form and structure of organisms
(plants, animals, and other forms of life).
Multidisciplinary team meeting A meeting which is held on a regular basis, which is made up of participants from various disciplines appropriate to the disease area, where diagnosis, management, and appropriate treatment of patients is discussed and decided.
Multifocal disease Occurring in more than one location in the breast.
Neoadjuvant therapy / treatment Drug treatment which is given before the treatment of a primary tumour with the aim of improving the results of surgery or chemotherapy and preventing the development of metastases.
Observed survival A method of estimating the actual survival prospects of patients following diagnosis. Includes deaths from all causes and does not adjust for underlying differences in patient populations.
Pathological The study of disease processes with the aim of understanding their nature and causes. This is achieved by observing samples of fluid and tissues obtained from the living patient by various methods, or at post mortem.
Prognostic indicators Factors, such as staging, tumour type or deprivation that may influence treatment effectiveness and outcomes.
Psychological Having to do with how the mind works and how thoughts and feelings affect behaviour.
Radiotherapy The use of radiation, usually X-rays or gamma rays, to kill tumour cells.
Randomised Clinical Trials A study to test a specific drug or other treatment in which people are randomly assigned to two (or more) groups:

one (the experimental group) receiving the treatment that is being tested, and the other (the comparison or control group) receiving an alternative treatment, a placebo (dummy treatment) or no treatment. The two groups are followed up to compare differences in outcomes to see how effective the experimental treatment was. (Through randomisation, the groups should be similar in all aspects apart from the treatment they receive during the study.)
Recurrence When new cancer cells are detected at the site of the original tumour, following treatment.
Relative survival A method of estimating net survival. The ratio of observed survival divided by expected survival, where the expected survival is based on the life expectancy of the population (from lifetables). This can be thought of as a measure of the survival expectation after developing cancer, or the probability of survival from cancer in the absence of other causes of death.
Sentinel node biopsy The lymph node near a body organ or part of an organ which is thought to be the first reached by tissue fluid draining from that organ, this lymph node may be the one most likely to contain cancer cells if the cancer has begun to spread.
Staging Process of describing to what degree cancer has spread from its original site to another part of the body. Staging involves clinical, surgical and pathology assessments.
Surgery/Surgically Surgical removal of the tumour/lesion.
Surgical margins See Excision Margins
Survival The percentage of people in a study or treatment group who are alive for a certain period of time after they were diagnosed with or treated for a disease, such as cancer.
Trastuzumab A manufactured antibody (a small part of out immune defences) which is attracted to the HER2 receptor on some breast cancers. It signals to the immune system to destroy these cells.
Tumour/s A lump or mass of cells which can be either benign (not cancerous) or malignant.
Ultrasound An imaging test that bounces sound waves off tissues and converts the echoes into pictures.
Wide excision The removal of the breast lump together with some surrounding tissue.


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