Mannu Gurdeep S, Bettencourt-Silva Joao H, Ahmed Farid, Cunnick Giles
Oxford University Hospitals, NHS Trust, Oxford OX3 9DU, UK.
Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK ; Buckinghamshire NHS Healthcare Trust, Buckinghamshire HP11 2TT, UK.
Int J Breast Cancer. 2015;2015:104231. doi: 10.1155/2015/104231. Epub 2015 Nov 30.
Background. There is wide variation in the management of Ductal Carcinoma In Situ (DCIS) nationwide. We aimed to investigate whether the attitudes of surgeons towards different aspects of DCIS treatment varied by seniority of surgeon or by geographical region within the UK. Materials and Methods. A nationwide online survey targeted at UK breast surgeons was undertaken. The anonymous survey contained questions regarding demographics of respondents and specific questions regarding DCIS management that were identified as areas of uncertainty during a systematic search of the literature. Results. Responses from 80 surgeons were obtained. Approximately 57% were male and the majority were consultant or specialist registrar. Approximately 63% of participants were based in district general hospitals with all training deaneries represented. Surgeons' views on the prognosis and management of DCIS varied geographically across the UK and terminology for DCIS varied with surgeon seniority. Surgeons' views particularly differed from national guidance on indications for SLNB, tamoxifen, and follow-up practice. Conclusion. Our survey reaffirms that, irrespective of national guidelines and attempts at uniformity, there continues to be a wide variety of views amongst breast surgeons regarding the ideal management of DCIS. However, by quantifying this variation, it may be possible to take it into account when examining long-term trends in nationwide treatment data.
背景。全国范围内导管原位癌（DCIS）的治疗方式存在很大差异。我们旨在调查外科医生对DCIS治疗不同方面的态度是否因外科医生的资历或英国境内的地理区域而异。材料与方法。针对英国乳腺外科医生开展了一项全国性在线调查。这项匿名调查包含有关受访者人口统计学的问题以及关于DCIS管理的特定问题，这些问题是在对文献进行系统检索期间确定为存在不确定性的领域。结果。获得了80名外科医生的回复。约57%为男性，大多数是顾问医生或专科住院医师。约63%的参与者来自地区综合医院，涵盖了所有培训地区。英国各地外科医生对DCIS预后和管理的看法存在地域差异，DCIS的术语也因外科医生资历而异。外科医生的观点在前哨淋巴结活检（SLNB）、他莫昔芬的适应证以及随访实践方面尤其与国家指南不同。结论。我们的调查再次证实，无论国家指南以及统一的努力如何，乳腺外科医生对于DCIS的理想治疗仍存在各种各样的观点。然而，通过量化这种差异，在检查全国治疗数据的长期趋势时可能会考虑到这一点。
