This study examined whether Australian surgeons recommendations regarding systemic treatment (i.e. drugs that spread through the body to treat cancer cells wherever they are) are in line with BreastSurgANZ guidelines in patients diagnosed with early breast cancer between 2002 - 2016 and if these patients proceed to treatment.
The majority of Australian patients are being recommended for adjuvant (i.e. after surgery) systemic treatment in line with Key Performance Indicators set by BreastSurgANZ. The proportion of patients who then go on to have this treatment is very high (89%).
The treatment with the highest rate of being recommended but not received was hormone therapy (12%), with over half of these due to patients refusing the treatment.
Older patients were less likely to be recommended for chemotherapy, although, this has increased since the previous study which looked at cases diagnosed between 1998 and 2004.
Among patients who were recommended for chemotherapy, 3% did not receive it. One quarter of those who did not receive had refused the treatment. Patients who were older, those living in regional areas and those where the cancer had not spread to the lymph nodes were the most likely to refuse chemotherapy.
Finding out why patients are refusing their recommended treatment may help in planning what information is given to these patients, to increase their acceptance of recommendations, in turn, likely improving their outcomes. For regional patients, improvements in accessing treatments locally, may assist in the acceptance of recommended treatment as the distance and time spent away from home is likely to be affecting their choice.
NOTE: The BQA KPIs were updated in 2023. This research was based on previous KPIs.
Reference:
Chan A, O'Neil N, Lomma C, Chih H, Willsher P. BreastSurgANZ members recommendations for adjuvant systemic treatment and patient compliance in Australian breast cancer patients. ANZ J Surg. 2021 Nov;91(11):2418-2424. doi: 10.1111/ans.17175. Epub 2021 Sep 3. PMID: 34476882.