National breast cancer audit: ductal carcinoma in situ management in Australia and New Zealand

dc.contributor.authorCuncins-Hearn, A.
dc.contributor.authorBoult, M.
dc.contributor.authorBabidge, W.
dc.contributor.authorZorbas, H.
dc.contributor.authorVillanueva, E.
dc.contributor.authorEvans, A.
dc.contributor.authorOliver, D.
dc.contributor.authorKollias, J.
dc.contributor.authorReeve, T.
dc.contributor.authorMaddern, G.
dc.date.issued2007
dc.descriptionThe definitive version is available at www.blackwell-synergy.com
dc.description.abstractBackground: Ductal carcinoma in situ (DCIS) is a significant issue in Australia and New Zealand with rising incidence because of the implementation of mammographic screening. Current information on its natural history is unable to accurately predict progression to invasive cancer. In 2003, the National Breast Cancer Centre in Australia published recommendations for DCIS. In Australia and New Zealand, the National Breast Cancer Audit collects information on DCIS cases. This article will examine these recommendations and provide information from the audit on current DCIS management. Methods: Three thousand six hundred and twenty-nine cases of DCIS were entered by 274 breast surgeons between January 1998 and December 2004. Data items in the National Breast Cancer Audit database that were covered in the National Breast Cancer Centre recommendations were reviewed. Information was available on the following: diagnostic biopsy rates for all cases and mammographically positive cases and rates of breast conserving surgery (BCS), clear margins following BCS, postoperative radiotherapy following BCS for groups at high risk of recurrence as well as axillary procedures and tamoxifen prescription. Results: Close adherence was found in diagnostic biopsy, BCS and clear margin rates. Some high-risk groups received radiotherapy, although women with ‘close’ margins did not in 33% of cases. Axillary procedures were conducted in 23% of cases and most (81%) patients were not prescribed tamoxifen. Conclusion: There was predominantly close adherence to recommendations with three possible areas of improvement: fewer axillary procedures, an appraisal of radiotherapy practice following BCS and more investigation into tamoxifen prescription practices for DCIS.
dc.description.statementofresponsibilityAstrid Cuncins-Hearn, Margaret Boult, Wendy Babidge, Helen Zorbas, Elmer Villanueva, Alison Evans, David Oliver, James Kollias, Tom Reeve and Guy Maddern
dc.identifier.citationANZ Journal of Surgery, 2007; 77(1-2):64-68
dc.identifier.doi10.1111/j.1445-2197.2006.03979.x
dc.identifier.issn1445-1433
dc.identifier.issn1445-2197
dc.identifier.orcidBoult, M. [0000-0002-0517-9535]
dc.identifier.orcidBabidge, W. [0000-0002-7063-7192]
dc.identifier.orcidMaddern, G. [0000-0003-2064-181X]
dc.identifier.urihttp://hdl.handle.net/2440/43021
dc.language.isoen
dc.publisherBlackwell Science Asia
dc.source.urihttps://doi.org/10.1111/j.1445-2197.2006.03979.x
dc.subjectBreast
dc.subjectAxilla
dc.subjectHumans
dc.subjectCarcinoma, Intraductal, Noninfiltrating
dc.subjectBreast Neoplasms
dc.subjectTamoxifen
dc.subjectAntineoplastic Agents, Hormonal
dc.subjectMammography
dc.subjectBiopsy
dc.subjectRadiotherapy, Adjuvant
dc.subjectLymph Node Excision
dc.subjectMastectomy, Segmental
dc.subjectMiddle Aged
dc.subjectGuideline Adherence
dc.subjectMedical Audit
dc.subjectAustralia
dc.subjectNew Zealand
dc.subjectFemale
dc.titleNational breast cancer audit: ductal carcinoma in situ management in Australia and New Zealand
dc.typeJournal article
pubs.publication-statusPublished

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