Department of Oncology, University Hospital of Udine, Italy; School of Medical Oncology, Department of Medicine, University of Udine, Italy.
Department of Oncology, University Hospital of Udine, Italy; School of Medical Oncology, Department of Medicine, University of Udine, Italy.
Breast. 2018 Aug;40:45-52. doi: 10.1016/j.breast.2018.04.011. Epub 2018 Apr 19.
The optimal strategy for monitoring metastatic breast cancer (M-MBC) is unclear. Nevertheless, M-MBC influences patient's quality of life and it affects the use of resources in terms of both drugs and diagnostic exam prescription. We aim to disclose oncologists' approach on M-MBC, identifying controversial areas.
An anonymous online survey was conducted among GIM members who, based on their on-field experience, shared their own method for M-MBC planning. Chi-square tests and Fisher exact tests were used as appropriate.
The survey was completed by 256 recipients (51%). The majority of them were medical oncologists. Approximately 50% of respondents reported that M-MBC was primarily based on the monitoring strategies used in clinical trials, and for 70% of them M-MBC should be evidence-based. Areas of controversies included the primary goal of M-MBC, the use of tumour markers, the optimal timing for baseline assessment and frequency of repeating testing. Respondents agreed on planning M-MBC before treatment's start and on discussing with the patient about the M-MBC strategy and on choosing CT-scan as the preferred reassessment imaging method. The most relevant factors influencing the M-MBC strategy were performance status, triple negative histology, exam's contraindication, the presence of clinically measurable disease, and treatment safety profile; on the contrary, patients' socio-economic status, exam's cost, and hospital's logistic limits were less relevant. Experienced oncologists seemed less prone to intensive follow-up.
M-MBC strategy still has controversial issues and its potential clinical effects for breast cancer patients need ad hoc studies.
转移性乳腺癌（M-MBC）的最佳监测策略尚不清楚。然而，M-MBC 会影响患者的生活质量，并在药物和诊断检查处方方面影响资源的使用。我们旨在揭示肿瘤学家对 M-MBC 的治疗方法，确定有争议的领域。
我们对 GIM 成员进行了一项匿名在线调查，根据他们的现场经验，分享他们自己的 M-MBC 规划方法。适当使用卡方检验和 Fisher 确切检验。
共有 256 名收件人（51%）完成了调查。他们中的大多数是肿瘤内科医生。大约 50%的受访者报告说，M-MBC 主要基于临床试验中使用的监测策略，而对于 70%的人来说，M-MBC 应该是基于证据的。有争议的领域包括 M-MBC 的主要目标、肿瘤标志物的使用、基线评估的最佳时机和重复测试的频率。受访者同意在治疗开始前规划 M-MBC，并与患者讨论 M-MBC 策略以及选择 CT 扫描作为首选的重新评估成像方法。影响 M-MBC 策略的最重要因素是表现状态、三阴性组织学、检查禁忌、临床可测量疾病的存在以及治疗安全性；相反，患者的社会经济状况、检查成本和医院的后勤限制则不那么重要。经验丰富的肿瘤学家似乎不太倾向于进行密集随访。
M-MBC 策略仍存在争议问题，其对乳腺癌患者的潜在临床效果需要专门研究。
