Adjuvant chemotherapy in node negative breast cancer: patterns of use and oncologists' preferences.
BACKGROUND
A worldwide variation in policy is seen regarding adjuvant systemic treatment for node negative breast cancer (NNBC). After the first presentations of the 10-year EBCTCG results, a study was carried out in the Netherlands to assess patterns of care and to obtain the views of oncologists as to what constitutes a worthwhile benefit from treatment.


METHODS
A questionnaire regarding patterns of use of and preferences for adjuvant chemotherapy in younger women was mailed to surgical, medical and radiation oncologists in the Netherlands.


RESULTS
Thirty-five percent stated that NNBC patients under 50 in their hospital never received adjuvant chemotherapy. The majority considered a 10-year survival gain of 6%-10% sufficient to warrant the use of chemotherapy in patients under 50. Surgical oncologists required a larger benefit from treatment than radiotherapists and medical oncologists. The more frequently oncologists treated patients in a research context, the less benefit they required from treatment to make it worthwhile.


CONCLUSIONS
Data such as these are valuable input into the process of guideline development, and may help discussion within the profession as to what benefit offsets the burden of treatment.
Stiggelbout
A M
AM
Department of Medical Decision Making, Leiden University Medical Center, The Netherlands. stiggelbout@rullf2.medfac.leidenuniv.nl
de Haes
J C
JC
van de Velde
C J
CJ
D000328:Adult; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008495:Medical Oncology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*