Anees Chagpar1, Gildy Babiera2, Jose Aguirre3, Philip Caropreso4, Tyler Hughes5. 1. Department of Surgery, Yale University School of Medicine, 20 York Street, First Floor, Suite A, New Haven, CT, 06510, USA; Breast Center, Smilow Cancer Hospital at Yale-New Haven, 20 York Street, First Floor, Suite A, New Haven, CT, 06510, USA. Electronic address: anees.chagpar@yale.edu. 2. The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. 3. Department of Surgery, Hospital de los Valles, Quito, Ecuador. 4. Department of Surgery, 1813 Grand Avenue, Keokuk, IA, USA. 5. Department of Surgery, McPherson Medical and Surgical Associates, McPherson, KS, USA.
Abstract
BACKGROUND: Despite guidelines, surgeons vary in the metastatic workup they order for their breast cancer patients. METHODS: Surgeons were surveyed as to their practices in ordering staging studies for their breast cancer patients using a Web-based survey. Nonparametric analyses were performed to determine factors associated with guideline adherence. RESULTS: Two hundred fifty-three surgeons responded to the survey; 55.8% had practices with ≥50% breast patients; 7.3% of respondents stated they always did a metastatic workup before surgery, 8.6% never did; only 52.4% ordered a metastatic workup only in patients with clinical stage III disease. Surgeons who had ≥50% breast-related practices were more likely to follow these guidelines (P = .031). Only 17% stated that a computed tomography chest/abdomen and bone scan was their "usual" metastatic workup. CONCLUSIONS: Nearly 40% of surgeons perform metastatic workup when they are not indicated, and few adhere to National Comprehensive Cancer Network guidelines in terms of the tests ordered.
BACKGROUND: Despite guidelines, surgeons vary in the metastatic workup they order for their breast cancerpatients. METHODS: Surgeons were surveyed as to their practices in ordering staging studies for their breast cancerpatients using a Web-based survey. Nonparametric analyses were performed to determine factors associated with guideline adherence. RESULTS: Two hundred fifty-three surgeons responded to the survey; 55.8% had practices with ≥50% breast patients; 7.3% of respondents stated they always did a metastatic workup before surgery, 8.6% never did; only 52.4% ordered a metastatic workup only in patients with clinical stage III disease. Surgeons who had ≥50% breast-related practices were more likely to follow these guidelines (P = .031). Only 17% stated that a computed tomography chest/abdomen and bone scan was their "usual" metastatic workup. CONCLUSIONS: Nearly 40% of surgeons perform metastatic workup when they are not indicated, and few adhere to National Comprehensive Cancer Network guidelines in terms of the tests ordered.