Me. Stark et Jp. Crowe, BREAST-CANCER EVALUATION AND FOLLOW-UP - A SURVEY OF THE OHIO CHAPTEROF THE AMERICAN-COLLEGE-OF-SURGEONS, The American surgeon, 62(6), 1996, pp. 458-460
Preoperative evaluation and postoperative follow-up of breast cancer p
atients vary considerably. Recent literature suggests that routine sur
veillance studies for breast cancer patients can be reduced without co
mpromising the outcome. The Ohio State Chapter of The American College
of Surgeons Committee on Cancer sponsored a survey of its general sur
geon fellows to determine their practice philosophies regarding these
issues. The questions centered around breast cancer screening, evaluat
ion and treatment, and follow-up. The fellows were also questioned as
to their opinions regarding practice parameters and whether the State
Chapter should fake a role in this area. Of the 764 surveys sent out,
34.2% were appropriate for evaluation. For breast cancer screening, 96
.1% believe yearly mammography is important. Newly diagnosed breast ca
ncer patients are generally evaluated with history and physical exam,
chest X-ray, complete blood cell count, and liver function tests. Bone
scans are used by 38.6% of surgeons. Most patients with positive lymp
h nodes see a medical oncologist. About half of primary breast cancer
treatment (44.7%) is by breast preservation. Essentially all surgeons
follow their patients after treatment for breast cancer surveillance.
Essentially all surgeons feel that physical exam and mammograms are im
portant for post-treatment follow-up. Complete blood cell count, liver
function studies, and chest X-rays are used less commonly but still b
y more than half of the surgeons. 44.4% of the surgeons have found dif
ficulty with third-party payers covering the costs of surveillance stu
dies. 87.7% of surgeons surveyed felt the State Chapter should become
involved in establishing clinical guidelines or practice parameters.