Evolution of breast cancer management in Ireland: a decade of change.
BACKGROUND
Over the last decade there has been a paradigm shift in the management of breast cancer, subsequent to revised surgical oncology guidelines and consensus statements which were derived in light of landmark breast cancer clinical trials conducted throughout the latter part of the 20th century. However the sheer impact of this paradigm shift upon all modalities of treatment, and the current trends in management of the disease, are largely unknown. We aimed to assess the changing practices of breast cancer management over the last decade within a specialist tertiary referral Breast Cancer Centre.


METHODS
Comparative analysis of all aspects of the management of breast cancer patients, who presented to a tertiary referral Breast Cancer Centre in 1995/1996 and 2005/2006, was undertaken and measured against The European Society for Surgical Oncology guidelines for the surgical management of mammographically detected lesions [1998].


RESULTS
613 patients' case profiles were analysed. Over the last decade we observed a dramatic increase in incidence of breast cancer [>100%], a move to less invasive diagnostic and surgical therapeutic techniques, as well as increased use of adjuvant therapies. We also witnessed the introduction of immediate breast reconstruction as part of routine practice


CONCLUSIONS
We demonstrate that radical changes have occurred in the management of breast cancer in the last decade, in keeping with international guidelines. It remains incumbent upon us to continue to adapt our practice patterns in light of emerging knowledge and best evidence.
Heneghan
Helen M
HM
Department of Surgery, National University of Ireland Galway, Ireland. helenheneghan@hotmail.com
Prichard
Ruth S
RS
Devaney
Amanda
A
Sweeney
Karl J
KJ
Malone
C
C
McLaughlin
Ray
R
Kerin
Michael J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000628:therapy; D003131:Combined Modality Therapy / Q000706:statistics & numerical data / Q000639:trends; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007494:Ireland; D008408:Mastectomy / Q000379:methods / Q000639:trends; D008875:Middle Aged; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D021701:Sentinel Lymph Node Biopsy