Therapeutic options for occult breast cancer: a survey of the American Society of Breast Surgeons and review of the literature.
BACKGROUND
Axillary presentation of occult breast cancer (OBC) is uncommon, and continues to be a diagnostic and therapeutic challenge to physicians. After our recent experience with a similar patient, a survey of the American Society of Breast Surgeons (ASBS) was conducted to assess the Society's member's opinions on treatment.


METHODS
A survey was sent by mail to 1837 members of the ASBS. The survey consisted of a brief case presentation after which the surgeon's preference for management of the breast was sought. The choices included "mastectomy," "whole breast radiation" or "other."


RESULTS
A total of 776 (42%) responses were received. The majority of respondents, 338 or 43%, preferred "mastectomy," while 285 or 37% opted for "whole breast radiation." Twenty percent of respondents (153 responses) chose "other," of which 46 physicians (6% of total) indicated they would observe the patient.


CONCLUSIONS
Although recent literature supports the use of whole breast radiation, these results demonstrate that a small majority of physicians still prefer mastectomy. The appropriate treatment of the breast after an axillary presentation of OBC continues to be a controversial issue.
Khandelwal
Anjay K
AK
Department of General Surgery, Temple University/Conemaugh Memorial Medical Center, 1086 Franklin St., Johnstown, PA 15905, USA. anjayk@juno.com
Garguilo
Gerard A
GA
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D011878:Radiotherapy
D000970:Antineoplastic Agents