Breast Cancer Outcomes at KFSYSCC
The Harvard Business School case study on KFSYSCC specifically highlights the center's innovative, integrated, team-based care delivery model for breast cancer. This model is tailored to provide comprehensive treatment plans that take into account every facet of patient care, from diagnosis to treatment to post-care support. Furthermore, the case study emphasizes the center's pay-for-performance reimbursement program for breast cancer care, a groundbreaking approach that focuses on the quality of treatment outcomes rather than just the volume of services provided.
For patients, this matters immensely. Traditional fee-for-service models incentivize quantity over quality; the more tests and procedures performed, the more the hospital gets paid. This can sometimes lead to unnecessary treatments that may not improve—and could potentially harm—the patient's health. In contrast, KFSYSCC's pay-for-performance model aligns the interests of the healthcare providers with those of the patient. Medical teams are incentivized to ensure successful treatment outcomes, which means more personalized, effective care for each patient.
Between 2015-2019, the five-year survival rate for breast cancer at KFSYSCC was 93.5% vs 85.2% for other hospitals in Taiwan.
Basic Information and Distribution of 16,540 Breast Cancer Patients at KFSYSCC from 1990-2019
| Total | 1990-1994 | 1995-1999 | 2000-2004 | 2005-2009 | 2010-2014 | 2015-2019 | |
|---|---|---|---|---|---|---|---|
| n | 16,540 | 337 (2%) | 1,028 (6%) | 2,687 (16%) | 3,915 (24%) | 4,485 (27%) | 4,088 (25%) |
| Gender (%) | |||||||
| Male | 40 (0.2%) | 2 (0.6%) | 2 (0.2%) | 9 (0.3%) | 13 (0.3%) | 10 (0.2%) | 4 (0.1%) |
| Female | 16,500 (99.8%) | 335 (99.4%) | 1,026 (99.8%) | 2,678 (99.7%) | ,902 (99.7%) | 4,475 (99.8%) | 4,084 (99.9%) |
| Age | |||||||
| Mean/Median | 51/49 | 50/46 | 48/46 | 49/48 | 50/49 | 51/50 | 52/51 |
| Range | 17-95 | 23-90 | 20-94 | 18-93 | 19-91 | 17-93 | 21-95 |
| Q1-Q3 | 43-58 | 40-59 | 40-55 | 41-55 | 43-56 | 44-58 | 45-60 |
| Stage (%) | |||||||
| 0 | 1,889 (11%) | 31 (9%) | 105 (10%) | 300 (11%) | 402 (10%) | 526 (12%) | 525 (13%) |
| I | 5,162 (31%) | 3 (19%) | 191 (19%) | 731 (27%) | 1,199 (31%) | 1,594 (36%) | 1,384 (34%) |
| II | 5,550 (34%) | 57 (17%) | 249 (24%) | 1,008 (38%) | 1,463 (37%) | 1,437 (32%) | 1,336 (33%) |
| III | 2,715 (16%) | 69 (20%) | 137 (13%) | 466 (17%) | 691 (18%) | 715 (16%) | 637 (16%) |
| IV | 757 (5%) | 24 (7%) | 57 (6%) | 133 (5%) | 150 (4%) | 207 (5%) | 186 (5%) |
| Unknown | 467 (3%) | 93 (28%) | 289 (28%) | 49 (2%) | 10 (0.3%) | 6 (0.1%) | 20 (1%) |
Based on KFSYSCC's cancer registry from 1990 to 2019, there were 16,540 analytic breast cancer cases, with 40 males (0.2%) and 16,500 females (99.8%). The average and median ages were 51 and 49 years old, respectively; the youngest patient was 17 years old, and the oldest was 95 years old; the interquartile range (Q1-Q3) was 43-58. By stage, there were 1,889 stage 0 breast cancer patients (11%), 5,162 stage I patients (31%), 5,550 stage II patients (34%), 2,715 stage III patients (16%), and 757 stage IV patients (5%). The basic information and stage distribution of all breast cancer patients, sorted by the year of diagnosis, are presented in the table above.
Survival Curves for 16,540 Breast Cancer Patients (1990-2019), Stratified by Year of Diagnosis
From 1990 to 2019, this chart illustrates the five-year observed survival rates for 16,540 breast cancer patients at KFSYSCC, stratified by the year of diagnosis. The graph shows the five-year survival rate for breast cancer increased from 72% in 1990-1994 to 94% in 2015-2019, while the ten-year survival rate rose from 62% in 1990-1994 to 85% in 2010-2014.
Treatment Methods and Stages for 4,088 Breast Cancer Patients
at KFSYSCC (2015-2019)
| Category | Total | Stage 0 | Stage I | Stage II | Stage III | Stage IV | Unknown |
|---|---|---|---|---|---|---|---|
| Total | 4,088 | 525 | 1,384 | 1,336 | 637 | 186 | 20 |
| Surgical Treatment | 3,896 (95%) | 520 (99%) | 1,376 (99%) | 1,315 (98%) | 620 (97%) | 46 (25%) | 19 (95%) |
| Radiation Therapy | 2,725 (67%) | 251 (48%) | 836 (60%) | 973 (73%) | 574 (90%) | 85 (46%) | 6 (30%) |
| Chemotherapy | 2,444 (60%) | 1 (0.2%) | 535 (39%) | 1,152 (86%) | 610 (96%) | 145 (78%) | 1 (5%) |
| Targeted Therapy | 658 (16%) | 1 (0.2%) | 77 (6%) | 287 (21%) | 213 (33%) | 79 (42%) | 1 (5%) |
| Hormone Therapy | 2,612 (64%) | 127 (24%) | 1,023 (74%) | 956 (72%) | 409 (64%) | 92 (49%) | 5 (25%) |
| Immunotherapy | 15 (0.4%) | 0 (0%) | 0 (0%) | 8 (1%) | 6 (1%) | 1 (1%) | 0 (0%) |
| Palliative Care | 58 (1%) | 0 (0%) | 0 (0%) | 0 (0%) | 3 (0.5%) | 55 (30%) | 0 (0%) |
| Bone Marrow/Stem Cell Transplant | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| No Record of Initial Treatment Reported | 1 (0.02%) | 1 (0.2%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
Between 2015 and 2019, there were a total of 4,088 analytic breast cancer cases, including 525 patients in stage 0, 1,384 in stage I, 1,336 in stage II, 637 in stage III, and 186 in stage IV. In terms of treatment methods, 3,896 patients (95%) underwent surgical treatment, 2,725 (67%) received radiation therapy, 2,444 (60%) underwent chemotherapy, 658 (16%) received hormone therapy, 2,612 (64%) underwent immunotherapy, 58 (1%) received palliative care, and 1 (0.02%) had no record of initial treatment reported.
Five-Year Survival Rates of 4,088 Breast Cancer Patients by Stage (2015-2019)
KFSYSCC’s 2015-2019 five-year observed survival rates for 4,088 breast cancer patients, stratified by stage, are presented in the accompanying chart. As shown in the graph, the five-year survival rate is 99% for stage 0, 98% for stage 1, 97% for stage 2, 88% for stage 3, and 40% for stage 4.