Skip to main content
NCBI home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1988 Jun;57(6):630–634. doi: 10.1038/bjc.1988.144

Survey of treatment of primary breast cancer in Italy. GIVIO (Interdisciplinary Group for Cancer Care Evaluation).

PMCID: PMC2246476  PMID: 3408649

Abstract

A mail survey among 970 physicians from different specialties was carried out in Italy to learn about factors that influence physicians' decision-making for patients with early breast cancer. Ninety percent of respondents were in favour of a conservative procedure for the surgical treatment of a 35-year-old patient with primary tumour smaller than two centimeters. The same preference was also expressed by 66% of doctors for a 60-year-old patient with similar disease. Most physicians (78%) favoured the use of adjuvant chemotherapy for premenopausal node-positive women. Preferences for the treatment of post-menopausal patients were divided among those in favour of endocrine therapy (51%), chemotherapy (32%), the combination of the two (7%) or no further treatment after surgery (8%). Several factors appeared to relate to therapeutic preferences. Each physician's specialty was the single most important factor associated with the preference for surgical treatment together with the attitude towards patients' involvement in decision-making which, however, was statistically significant only for the older patient. Analysis of predictors of preferences for adjuvant therapy showed that specialty and hospital size were associated with choosing chemotherapy for a premenopausal woman, and specialty and physician's sex with the indication of endocrine treatment in a postmenopausal patient. Our study documents that the application of research results depends on many factors, some of which have a sound scientific basis while others reflect highly personal opinions and the influence of the practice environment.

Full text

PDF
630

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cataliotti L., Ciatto S., Rosselli Del Turco M., Distante V. New trends in the surgical treatment of primary breast cancer in the Florence District: 1979-1985. Tumori. 1986 Dec 31;72(6):581–584. doi: 10.1177/030089168607200607. [DOI] [PubMed] [Google Scholar]
  2. Fisher B., Bauer M., Margolese R., Poisson R., Pilch Y., Redmond C., Fisher E., Wolmark N., Deutsch M., Montague E. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med. 1985 Mar 14;312(11):665–673. doi: 10.1056/NEJM198503143121101. [DOI] [PubMed] [Google Scholar]
  3. Gazet J. C., Rainsbury R. M., Ford H. T., Powles T. J., Coombes R. C. Survey of treatment of primary breast cancer in Great Britain. Br Med J (Clin Res Ed) 1985 Jun 15;290(6484):1793–1795. doi: 10.1136/bmj.290.6484.1793. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Greenberg E. R., Stevens M. Recent trends in breast surgery in the United States and United Kingdom. Br Med J (Clin Res Ed) 1986 Jun 7;292(6534):1487–1491. doi: 10.1136/bmj.292.6534.1487. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Harris J. R., Beadle G. F., Hellman S. Clinical studies on the use of radiation therapy as primary treatment of early breast cancer. Cancer. 1984 Feb 1;53(3 Suppl):705–711. doi: 10.1002/1097-0142(19840201)53:3+<705::aid-cncr2820531319>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  6. Harris J. R., Hellman S., Kinne D. W. Limited surgery and radiotherapy for early breast cancer. N Engl J Med. 1985 Nov 21;313(21):1365–1368. doi: 10.1056/nejm198511213132128. [DOI] [PubMed] [Google Scholar]
  7. Himel H. N., Liberati A., Gelber R. D., Chalmers T. C. Adjuvant chemotherapy for breast cancer. A pooled estimate based on published randomized control trials. JAMA. 1986 Sep 5;256(9):1148–1159. doi: 10.1001/jama.256.9.1148. [DOI] [PubMed] [Google Scholar]
  8. Liberati A., Patterson W. B., Biener L., McNeil B. J. Determinants of physicians' preferences for alternative treatments in women with early breast cancer. Tumori. 1987 Dec 31;73(6):601–609. doi: 10.1177/030089168707300609. [DOI] [PubMed] [Google Scholar]
  9. Montague E. D. Conservation surgery and radiation therapy in the treatment of operable breast cancer. Cancer. 1984 Feb 1;53(3 Suppl):700–704. doi: 10.1002/1097-0142(19840201)53:3+<700::aid-cncr2820531318>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  10. Simon R. Overviews of randomized clinical trials. Cancer Treat Rep. 1987 Jan;71(1):3–5. [PubMed] [Google Scholar]
  11. Vana J., Bedwani R., Mettlin C., Murphy G. P. Trends in diagnosis and management of breast cancer in the U.S.: from the surveys of the American College of Surgeons. Cancer. 1981 Aug 15;48(4):1043–1052. doi: 10.1002/1097-0142(19810815)48:4<1043::aid-cncr2820480432>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES