title: A cross-sectional survey of the diagnosis and management of bone metastasis in breast cancer patients in Turkey.
abstract: OBJECTIVE
  This study aimed to report the practice of managing breast cancer with bone metastasis in Turkey and to determine the adherence to the British Association of Surgical Oncology (BASO) guidelines.
  
  
  METHODS
  This multicenter, cross-sectional epidemiological survey was conducted in 38 centers across Turkey. Data from 1,026 breast cancer patients with bone metastases (mean age 54.0 ± 11.9 years) were analyzed.
  
  
  RESULTS
  Over 30 % of patients had a diagnosis of metastatic breast cancer (stage IV) at the time of primary diagnosis. The imaging modalities used for diagnosing bone metastases were bone scintigraphy (57.8 %), radiography (22.8 %), and bone survey (4.4 %). Tumor markers were detected in 94.9 %, and markers of bone metabolism were measured in 90.4 % of patients. A total of 3.5 % of patients underwent surgery for bone metastasis, 26.4 % underwent palliative chemotherapy (most commonly docetaxel + capecitabine), and 56.5 % endured radiotherapy. Most patients (96 %) also received bisphosphonate. Radiography, bone scintigraphy, and CT were the main imaging tools used for postoperative follow-up of bone metastasis. Our results were >95 % in line with the BASO guidelines for the management of bone metastasis, except that interventional procedures, such as biopsy, were applied less frequently in our survey.
  
  
  CONCLUSIONS
  The diagnosis and management practices of breast cancer with bone metastasis in Turkey were generally compatible with international guidelines. However, the awareness and knowledge of physicians on the current guidelines should be increased, and equipment for the appropriate interventional procedures should be provided in every clinic to obtain optimal and standard management of bone metastases.
authors.affiliation: Department of Medical Oncology, Mersin University Hospital, Mersin, Turkey, dr.arican@gmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Arican
authors.forename: Tulin
authors.initials: T
authors.lastname: Bozkurt
authors.forename: Hakan
authors.initials: H
authors.lastname: Bozcuk
authors.forename: Binnaz
authors.initials: B
authors.lastname: Demirkan
authors.forename: Suleyman
authors.initials: S
authors.lastname: Buyukberber
authors.forename: Necati
authors.initials: N
authors.lastname: Alkis
authors.forename: Ulus Ali
authors.initials: UA
authors.lastname: Sanli
authors.forename: Celalettin
authors.initials: C
authors.lastname: Camci
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yildiz
authors.forename: Idris
authors.initials: I
authors.lastname: Yucel
authors.forename: Kazim
authors.initials: K
authors.lastname: Uygun
authors.forename: Isik
authors.initials: I
authors.lastname: Aslay
authors.forename: Mutlu
authors.initials: M
authors.lastname: Demiray
authors.forename: Nuran Senel
authors.initials: NS
authors.lastname: Bese
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Isikdogan
authors.forename: Zumrut
authors.initials: Z
authors.lastname: Bahat
authors.forename: Cengiz
authors.initials: C
authors.lastname: Gemici
authors.forename: Feyyaz
authors.initials: F
authors.lastname: Ozdemir
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozdener
authors.forename: Bahadir
authors.initials: B
authors.lastname: Pekin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000628:therapy; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D014421:Turkey; D055815:Young Adult
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