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Breast cancer surgery in New Zealand: consensus or variation?
J Morris1, B McNoe, J M Elwood
1Department of Preventive and Social Medicine, University of Otago, Dunedin.
Aims:
To explore how patients with early breast cancer are managed surgically in New Zealand.
Methods:
A questionnaire was mailed to 195 surgeons registered as general surgeons.
Results:
Replies were received from 112 of the 186 currently working surgeons (60%), of whom 76 indicated that they treated patients with breast disease. Six per cent indicated that they treated > 50 newly diagnosed breast cancer patients in 1994. A minority, 29%, had formal protocols documented for the surgical management of breast cancer patients in their unit. One-third would make the decision about treatment themselves, two-thirds would involve other specialties. Almost all would offer the patient a choice of treatment when this was appropriate. Only 9% would recommend mastectomy for a T1/2NO tumour located in the upper outer breast quadrant. There were no significant differences between surgeons when divided by regional health authority, type of hospital and numbers of patients treated annually.
Conclusions:
There appears to be agreement amongst surgeons regarding the preferred form of surgical treatment of patients with stage I or II disease. The results indicate that the surgical treatment of early stage disease is consistent with published guidelines.