title: Reducing the global breast cancer burden: the importance of patterns of care research.
abstract: Breast cancer treatment guidelines are not uniformly followed in clinical practice, with evidence for substantial variations in treatment patterns, quality of care, and patient outcomes among and within countries. The factors that drive treatment decisions are unclear. Furthermore, the impact of different treatment strategies on survival is poorly understood outside the clinical trial setting. Sources of patterns of care information often have limitations in completeness, quality, timeliness of reporting, and relevance to the larger population. Patterns of care studies frequently lack details on cancer stage at diagnosis, tumor biology, and treatment received. It is difficult to compare data between studies and/or track changes over time because of variations in data sources and collection techniques. Thus, the design and implementation of a global registry is sorely needed in order to prospectively evaluate worldwide patterns of care and outcomes in patients with breast cancer. Components of this registry should include random selection of centers of variable practice settings in multiple countries and accurate and rapid data reporting at prestudy and follow-up timepoints. Data collected would include tumor and demographic factors, staging information, treatment rendered, and survival. Variables that influenced the treatment selected would be assessed. This unique international effort would allow the development of strategies to improve diagnostic and treatment-related standards of care and survival outcomes, thus reducing the breast cancer burden worldwide.
authors.affiliation: Loyola University Chicago Strich School of Medicine, Cardinal Bernardin Cancer Center, Maywood, IL 60153, USA. kalbain@lumc.edu
authors.forename: Kathy S
authors.initials: KS
authors.lastname: Albain
authors.forename: Jaime
authors.initials: J
authors.lastname: de la Garza Salazar
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Pienkowski
authors.forename: Matti
authors.initials: M
authors.lastname: Aapro
authors.forename: Jonas
authors.initials: J
authors.lastname: Bergh
authors.forename: Maira
authors.initials: M
authors.lastname: Caleffi
authors.forename: Robert
authors.initials: R
authors.lastname: Coleman
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Eiermann
authors.forename: Fikri
authors.initials: F
authors.lastname: Icli
authors.forename: Mark
authors.initials: M
authors.lastname: Pegram
authors.forename: Martine
authors.initials: M
authors.lastname: Piccart
authors.forename: Raymond
authors.initials: R
authors.lastname: Snyder
authors.forename: Masakazu
authors.initials: M
authors.lastname: Toi
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000639:trends; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome