Background: 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. Methods: 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. Results: 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. Conclusion: M-MBC strategy still has controversial issues and its potential clinical effects for breast cancer patients need ad hoc studies.
Controversies in monitoring metastatic breast cancer during systemic treatment. Results of a GIM (Gruppo Italiano Mammella) survey / Bonotto, M.; Basile, D.; Gerratana, L.; Pelizzari, G.; Bartoletti, M.; Vitale, M. G.; Fanotto, V.; Lisanti, C.; Mansutti, M.; Minisini, A. M.; Aprile, G.; De Laurentiis, M.; Montemurro, F.; Del Mastro, L.; Puglisi, F.. - In: THE BREAST. - ISSN 0960-9776. - 40:(2018), pp. 45-52. [10.1016/j.breast.2018.04.011]
Controversies in monitoring metastatic breast cancer during systemic treatment. Results of a GIM (Gruppo Italiano Mammella) survey
De Laurentiis M.;
2018
Abstract
Background: 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. Methods: 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. Results: 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. Conclusion: M-MBC strategy still has controversial issues and its potential clinical effects for breast cancer patients need ad hoc studies.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
