Intra-European differences in the radiotherapeutic management of breast cancer: a survey study.

AIMS: To document and explain self-reported practices of the radiotherapeutic management of breast cancer within different European regions. METHODS: An original survey questionnaire was developed to assess radiation oncologists' self-reported management of breast cancer. The questionnaire was distributed to physician members of the American Society for Therapeutic Radiology and Oncology and the European Society of Therapeutic Radiation Oncology. This paper presents the results of the comparative analysis of 702 responses from North America and 435 responses from Europe. RESULTS: Several areas of variation are identified. These include the selection criteria for post-mastectomy radiation and radiation for ductal carcinoma in situ (DCIS). Variations are also seen in the management of regional lymph nodes after lumpectomy, and radiation dose and fractionation. CONCLUSIONS: Radiation oncologists within Europe vary in their self-reported practices for managing women with breast cancer. These differences may be rooted in deeper cultural differences and differences in the healthcare systems of different European countries. They may also reflect differences in the relative weight radiation oncologists place upon data generated within their own countries. These results support the need for co-operative group trials to provide evidence for more uniform treatment recommendations and policies.

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