SURVEY OF THE MANAGEMENT OF PRIMARY BREAST CANCER IN WESTERN AUSTRALIA

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Abstract
A postal survey of all general surgeons in Western Australia was undertaken in order to document their current attitudes towards the management of primary breast cancer. The commonest surgical procedure preferred for stages I and II breast cancer was a modified radical mastectomy, although a substantial number (31%) of surgeons favour breast conserving procedures for primary tumours less than 2 cm in size. Few (3%) surgeons still perform a classical radical or extended radical mastectomy. There is a wide diversity of practices regarding pre-operative investigations and postoperative management. Although many surgeons (68%) use aspiration cytology to determine the histologic nature of breast lumps, the majority (62%) do not use mammography to monitor the contralateral breast. After breast conserving surgery, 60% of surgeons would not refer their patients for adjuvant radiotherapy and over 33% would not favour the use of adjuvant systemic therapy for women with stage II breast cancer. It is concluded that the wide diversity in the pattern of management reflects uncertainty regarding the best approach to this disease.