title: Questionnaire survey of treatment choice for breast cancer patients with brain metastasis in Japan: results of a nationwide survey by the task force of the Japanese Breast Cancer Society.
abstract: OBJECTIVE
  A nationwide survey was performed to investigate the current patterns of care for brain metastasis (BM) from breast cancer in Japan.
  
  
  METHODS
  A total of 351 survey questionnaires were sent to community or academic breast oncologists who were members of the Japanese Breast Cancer Society as of December 2005. The questionnaire consists of 40 multiple choice questions in eight categories.
  
  
  RESULTS
  Of 240 institutions sent survey questionnaires, 161 (67.1%) answered; 60% of institutions answered with '<5' patients with BM every year; almost half (83 of 161) screened for BM in asymptomatic patients; surgical resection was rarely performed, as ~75% of institutions (118 of 160 institutions) answered 'none or one case of surgery per year'; 27% (41 of 154) preferred stereotactic radiosurgery (SRS) over whole-brain radiotherapy (WBRT) as the initial treatment in all cases, although ~70% (100 of 154) of them answered 'depend on cases'. The preference for SRS over WBRT mainly depends on the impressions of breast oncologists about both safety (late normal tissue damage and dementia in WBRT) and efficacy (better local control by SRS). Eighty-one percent (117 of 144) of institutions did not limit the number of SRS sessions as far as technically applicable.
  
  
  CONCLUSIONS
  SRS is widely used as the first choice for BM from breast cancer in Japan. Considerable numbers of Japanese breast oncologists prefer SRS over WBRT as the initial treatment for BM. A randomized trial comparing SRS and WBRT is warranted.
authors.affiliation: Hyogo Cancer Center, Division of Medical Oncology, Akashi, Hyogo, Japan. kojmatsu@hp.pref.hyogo.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Ando
authors.forename: Chikako
authors.initials: C
authors.lastname: Yamauchi
authors.forename: Chiyomi
authors.initials: C
authors.lastname: Egawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hamamoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kataoka
authors.forename: Takashi
authors.initials: T
authors.lastname: Shuto
authors.forename: Kumiko
authors.initials: K
authors.lastname: Karasawa
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kurosumi
authors.forename: Norimichi
authors.initials: N
authors.lastname: Kan
authors.forename: Michihide
authors.initials: M
authors.lastname: Mitsumori
mesh_terms: D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D001943:Breast Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D006306:Health Surveys; D006801:Humans; D010818:Practice Patterns, Physicians'; D016634:Radiosurgery; D011795:Surveys and Questionnaires