The patterns of care study for breast-conserving therapy in Japan: analysis of process survey from 1995 to 1997.
OBJECTIVE
To present the results of a process survey on breast-conserving therapy (BCT) in Japan from 1995 to 1997.


METHODS
From September 1998 to December 1999, data on the treatment process of 865 randomly selected BCT patients were collected by extramural audits.


RESULTS
For primary surgery, wide excision or tumorectomy was performed in 372 patients (43.0%), and quadrantectomy or segmental mastectomy was performed in 493 patients (57%). The extent of axillary dissection was equal or beyond Level II in 590 patients (68.2%). Systemic chemotherapy was administered to 103 of 160 node-positive patients (64.4%) and 180 of 569 node-negative patients (31.6%). Tamoxifen was administered to 234 of 323 hormone receptor-positive patients (72.5%) and 68 of 130 hormone receptor-negative patients (52.3%). Photon energy of 10 MV was administered for whole breast irradiation in 38 patients (4.4%) without bolus.


CONCLUSIONS
The extent of surgical resection for BCT was large in Japan. Pathologic assessment and the technique of radiation therapy were apparently suboptimal in some cases. Information on prognostic/predictive factors was not fully utilized to individualize systemic adjuvant therapy. Establishment and widespread use of guidelines for BCT for in Japan are desirable. Repeated surveys will demonstrate how such guidelines affect clinical practices.
Mitsumori
Michihide
M
Department of Therapeutic Radiology and Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. mitsumo@kuhp.kyoto-u.ac.jp
Hiraoka
Masahiro
M
Negoro
Yoshiharu
Y
Yamauchi
Chikako
C
Shikama
Naoto
N
Sasaki
Shigeru
S
Yamamoto
Tokihiro
T
Teshima
Teruki
T
Inoue
Toshihiko
T
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007564:Japan; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D013629:Tamoxifen / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen