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Results of a survey regarding irradiation of internal mammary chain in patients with breast cancer: Practice is culture driven rather than evidence based

Taghian, A; Jagsi, R; Makris, A; Goldberg, S; Ceilley, E; Grignon, L; Powell, S; (2004) Results of a survey regarding irradiation of internal mammary chain in patients with breast cancer: Practice is culture driven rather than evidence based. International Journal of Radiation Oncology Biology Physics , 60 (3) pp. 706-714.

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Abstract

Purpose: To examine the self-reported practice patterns of radiation oncologists in North America and Europe regarding radiotherapy to the internal mammary lymph node chain (IMC) in breast cancer patients. Methods and Materials: A survey questionnaire was sent in 2001 to physician members of the American Society for Therapeutic Radiology and Oncology and European Society for Therapeutic Radiology and Oncology regarding their management of breast cancer. Respondents were asked whether they would treat the IMC in several clinical scenarios. Results: A total of 435 responses were obtained from European and 702 responses from North American radiation oncologists. Respondents were increasingly likely to report IMC irradiation in scenarios with greater axillary involvement. Responses varied widely among different European regions, the United States, and Canada (p < 0.01). European respondents were more likely to treat the IMC (p < 0.01) than their North American counterparts. Academic physicians were more likely to treat the IMC than those in nonacademic positions (p < 0.01). Conclusion: The results of this study revealed significant international variation in attitudes regarding treatment of the IMC. The international patterns of variation mirror the divergent conclusions of studies conducted in the different regions, indicating that physicians may rely preferentially on evidence from local studies when making difficult treatment decisions. These variations in self-reported practice patterns indicate the need for greater data in this area, particularly from international cooperative trials. The cultural predispositions documented in this study are important to recognize, because they may continue to affect physician attitudes and practices, even as greater evidence accumulates. (C) 2004 Elsevier Inc

Type: Article
Title: Results of a survey regarding irradiation of internal mammary chain in patients with breast cancer: Practice is culture driven rather than evidence based
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Keywords: AMERICAN-SOCIETY, breast cancer, CANCER, CANCER PATIENTS, CARCINOMA, CULTURE, DISSECTION, HEALTH, internal mammary lymph nodes, IRRADIATION, LYMPH-NODES, MANAGEMENT, PATTERNS, POSTOPERATIVE RADIOTHERAPY, practice patterns, PREMENOPAUSAL WOMEN, RADIATION, RADICAL-MASTECTOMY, radiotherapy, RANDOMIZED-TRIAL, response, RISK, STAGE- II, survey, TRIAL, TRIALS
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: http://discovery.ucl.ac.uk/id/eprint/36745
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