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Type: Journal article
Title: The management of early breast carcinoma before and after the introduction of clinical practice guidelines
Author: White, V.
Pruden, M.
Giles, G.
Collins, J.
Jamrozik, K.
Inglis, G.
Boyages, J.
Hill, D.
Citation: Cancer, 2004; 101(3):476-485
Publisher: John Wiley & Sons Inc
Issue Date: 2004
ISSN: 0008-543X
Statement of
Victoria White, Myee Pruden, Graham Giles, John Collins, Konrad Jamrozik, Graeme Inglis, John Boyages and David Hill
Abstract: BACKGROUND Clinical practice guidelines for the management of breast carcinoma were introduced in Australia in October, 1995. This article describes the management of early-stage breast carcinoma both before and after the introduction of these guidelines. METHODS All cases of early breast carcinoma that were diagnosed over the same 6-month period in 1995 and 1999 and registered with a state-based cancer registry were identified. Treating surgeons completed a survey assessing tumor characteristics and primary treatment. In 1995, 95% of 188 surgeons who were approached participated and 96% of the surveys were returned. In 1999, 92% of 159 surgeons who were approached participated and 91% of the surveys were returned. Analyses are based on 1066 cases from 1995 and 1001 cases from 1999. RESULTS The pathologic disease stage of the patients was similar in both study years. The proportion of patients who underwent breast-conserving therapy (BCT) increased from 54% in 1995 to 69% in 1999. This increase was noted across most levels of disease characteristics but was not evident among those patients treated by the least active surgeons. The proportion of patients treated with BCT who received radiotherapy increased from 59% in 1995 to 80% in 1999. This trend was observed across most levels of tumor characteristics and surgeon caseload. The proportion of women with receptor-positive tumors who were treated with endocrine therapy increased, whereas the proportion of patients with receptor-negative tumors who received this therapy decreased from 39% in 1995 to 17% in 1999. CONCLUSIONS The management of early breast carcinoma in the state of Victoria appeared to change between 1995 and 1999 in the direction expected if the national guidelines had been incorporated into the practice patterns of surgeons treating breast carcinoma patients.
Keywords: breast; clinical practice guidelines; management; population-based
Rights: © 2004 American Cancer Society
RMID: 0020081327
DOI: 10.1002/cncr.20401
Appears in Collections:Public Health publications

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