A global study of nearly 10,000 women with early breast cancer has found wide variations in how they were treated, despite international consensus on best practice, according to the May issue of the British Journal of Surgery .
Researchers from Europe, Japan and America compared 9,779 women with an average age of 64 from 566 study sites in Belgium, France, Germany, Greece, Japan, the Netherlands, the UK/Ireland and the USA.
"The primary aim of our five-year research study was to carry out an international randomised trial to evaluate the efficacy and safety of the breast cancer drug exemestane, alone or following tamoxifen" explains co-author Professor C J H van de Velde from Leiden University Medical Center in The Netherlands.
"However, because we had recruited a large number of patients, we decided that this also provided us with an invaluable opportunity to examine how different countries treat postmenopausal women with early breast cancer.
"The results of our study show wide international variations in the percentages of women who receive breast conserving surgery (BCS) rather than breast removal (mastectomy) and radiotherapy after surgery.
Key findings of the study included
"Our study showed that despite international consensus guidelines, there are wide global variations in the way postmenopausal women are treated for early breast cancer" concludes Professor van de Velde.
"We believe that there should be further efforts to ensure that women can all benefit from the most effective breast cancer treatment available, regardless of which country they live in."
The TEAM (Tamoxifen and Exemestane Adjuvant Multinational) trial covered nine countries: Belgium (414 women), France (1,230), Germany (1,471), Greece (207), Japan (184), The Netherlands (2,753), UK and Ireland (1,275) and USA (2,232).
A 20-minute podcast, produced to coincide with publication of the paper, can be accessed at http://www.ph-wt.com/blackwell/BJS/BJS290310.mp3
The paper is free online at: http://www3.interscience.wiley.com/cgi-bin/fulltext/123333400/PDFSTART
Notes to editors
Variations in locoregional therapy in postmenopausal patients with early breast cancer treated in different countries. van Nes et al. British Journal of Surgery . 97(5), pp 671-679. (May 2010). DOI: 10.1002/bjs.6962
The full paper includes extensive data on each country, including: eligibility criteria and protocols; comparison of patients and tumour characteristics; locoregional treatment characteristics and analysis of factors associated with type of surgery, including age, BMI and tumour size.
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