ABSTRACT
This paper describes the findings of a region-wide audit undertaken in 1995-1996 of post-operative radiotherapy treatment for patients with screen-detected breast cancer. The study covers the first 3 years from the start of the South Thames (East) Breast Screening Programme in June 1988 up to March 1992. The audit shows that only 60% of the patients with invasive carcinoma who were treated by conservation surgery are known to have received radiotherapy. A considerable variation in referral patterns was observed across the region. Analysis suggests that whilst geographical, patient choice and tumour factors may play an important role in the selection of patients for radiotherapy treatment after conservative surgery for early breast cancer, management protocols of surgical units were the most critical factor, and that these appear to vary, depending on the level of involvement of the clinician with the screening programme (as measured by case-load).
Subject(s)
Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Practice Patterns, Physicians'/statistics & numerical data , Referral and Consultation/statistics & numerical data , Breast Neoplasms/pathology , Data Collection , Female , Humans , London , Mass Screening/statistics & numerical data , Medical Audit , Postoperative Period , Quality Assurance, Health Care , Radiotherapy, Adjuvant/statistics & numerical data , Retrospective StudiesABSTRACT
This paper stems from a region-wide audit of postoperative radiotherapy treatment for patients with screen-detected breast cancer, commencing from the start of the South Thames (East) screening programme in June 1988 and ending in March 1992. It reports on the variation in treatment practices amongst clinical oncologists in the region. There was diversity in treatment schedules, dose specification points, and the use of lymph node radiotherapy, breast boost and interstitial implants. While local protocols vary by centre and individual oncologist, many treatment decisions appear to have been dictated by the availability of machines and other resources. However, further analysis suggests that the variation is within the same range as that described in the nationwide survey of breast radiotherapy by the Audit Office of the Royal College of Radiologists in 1995 [1-3].
