Breast cancer "tailored follow-up" in Italian oncology units: a web-based survey.
OBJECTIVE
Breast cancer follow-up procedures after primary treatment are still a controversial issue. Aim of this study was to investigate, through a web-based survey, surveillance methodologies selected by Italian oncologists in everyday clinical practice.


METHODS
Referents of Italian medical oncology units were invited to participate to the study via e-mail through the SurveyMonkey website. Participants were asked how, in their institution, exams of disease staging and follow-up are planned in asymptomatic women and if surveillance continues beyond the 5th year.


RESULTS
Between February and May 2013, 125 out of 233 (53.6%) invited referents of Italian medical oncology units agreed to participate in the survey. Ninety-seven (77.6%) referents state that modalities of breast cancer follow-up are planned according to the risk of disease progression at diagnosis and only 12 (9.6%) oncology units apply the minimal follow-up procedures according to international guidelines. Minimal follow-up is never applied in high risk asymptomatic women. Ninety-eight (78.4%) oncology units continue follow-up in all patients beyond 5 years.


CONCLUSIONS
Our survey shows that 90.4% of participating Italian oncology units declare they do not apply the minimal breast cancer follow-up procedures after primary treatment in asymptomatic women, as suggested by national and international guidelines. Interestingly, about 80.0% of interviewed referents performs the so called "tailored follow-up", high intensity for high risk, low intensity for low risk patients. There is an urgent need of randomized clinical trials able to determine the effectiveness of risk-based follow-up modalities, their ideal frequency and persistence in time.
Department of Experimental and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
Clara
C
Natoli
Department of Experimental and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
Davide
D
Brocco
Unit of Biostatistics, Regina Elena National Cancer Institute, Rome, Italy.
Isabella
I
Sperduti
Oncology Department, "Floraspe Renzetti" Hospital, Lanciano, Italy.
Antonio
A
Nuzzo
Department of Experimental and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
Nicola
N
Tinari
Department of Experimental and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
Michele
M
De Tursi
Department of Experimental and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
Antonino
A
Grassadonia
Clinical Governance Unit, "SS. Annunziata" Hospital, Chieti, Italy.
Lorenzo
L
Mazzilli
Department of Experimental and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
Stefano
S
Iacobelli
Department of Oncology, "S.S. Trinita'" Hospital, Sora, Italy.
Teresa
T
Gamucci
Division of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy.
Patrizia
P
Vici
D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D055502:Secondary Prevention