Chagpar Anees, Babiera Gildy, Aguirre Jose, Caropreso Philip, Hughes Tyler
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.
The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Am J Surg. 2015 Dec;210(6):1147-54.e2; discussion 1153-4. doi: 10.1016/j.amjsurg.2015.06.032. Epub 2015 Oct 27.
Despite guidelines, surgeons vary in the metastatic workup they order for their breast cancer patients.
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.
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.
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.
尽管有相关指南，但外科医生为乳腺癌患者安排的转移灶检查各不相同。
通过基于网络的调查，对外科医生为乳腺癌患者安排分期检查的做法进行了调查。采用非参数分析来确定与遵循指南相关的因素。
253名外科医生回复了调查；55.8%的医生处理过≥50%的乳腺癌患者；7.3%的受访者表示他们总是在手术前进行转移灶检查，8.6%的人从不这样做；只有52.4%的医生仅对临床III期疾病患者进行转移灶检查。处理过≥50%乳腺癌相关病例的外科医生更有可能遵循这些指南（P = 0.031）。只有17%的人表示胸部/腹部计算机断层扫描和骨扫描是他们“常用”的转移灶检查方法。
近40%的外科医生在不需要时进行转移灶检查，而且在安排的检查方面，很少有人遵循美国国立综合癌症网络的指南。
