Adherence to Treatment Guidelines in Breast Cancer Care – a Retrospective Analysis of the ‘Organgruppe Mamma der Arbeitsgemeinschaft Gynaekologische Onkologie’

Abstract

Background: The Organgruppe Mamma of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) performed a nationwide 3-phase analysis of the structure of care and standard of therapy given to patients with breast cancer from 2002 (4th quarter) to 2004 (4th quarter). The extent to which national and international treatment recommendations are implemented in routine clinical practice had so far not been evaluated in an interdisciplinary approach. No reliable data on the pattern of care of these patients have been published in Germany before. Patients and Methods: The project included early breast cancer in the adjuvant and neoadjuvant setting as well as metastatic disease. We present the results of phase III of the AGO analysis, which are based on a survey conducted by the Organkommission Mamma in the 4th quarter of 2004. Results: Evaluation of the data reveals that treatment based on the guidelines is now being implemented very reliably in certain sectors. This is of particular relevance to the pattern of adjuvant treatment in early breast cancer. In contrast, in metastatic breast cancer (MBC), the complexity of the interdisciplinary treatment approach is complicating this kind of straightforward analysis. Conclusion: The present analysis conducted by the AGO was the first attempt to analyse the treatment provided in patients presenting with MBC in a systematic fashion. The fundamental problem remains, irrespective of the stage of the tumour, that too few patients are treated in randomised clinical trials. The mission set by the AGO-Organkommission Mamma is the longitudinal observation of the therapy practices for breast cancer on the basis of the observations discussed here, which should ultimately benefit the optimisation of therapy quality in Germany.

The Impact of Breast Care Nurses on Patients’ Satisfaction, Understanding of the Disease, and Adherence to Adjuvant Endocrine Therapy

“…A total of 70% of breast cancer patients are eligible for adjuvant endocrine treatment. Therefore, adherence to standard guideline recommendations in breast cancer care is an important issue of health services research [12,13]. A high rate of non-compliance, or rather poor medication adherence, has already been demonstrated for women receiving routine cancer care outside clinical trials [14,15].…”

Disease management patterns for postmenopausal women in Europe with hormone-receptor-positive, human epidermal growth factor receptor-2 negative advanced breast cancer

“…For example, in Europe targeted therapies (e.g., bevacizumab and human epidermal growth factor receptor-2 [HER2] antagonists) are more likely to be used in France than in Germany and least likely to be used in the United Kingdom 5 . Furthermore, chemotherapy is used more frequently in Germany for advanced BC; in one study, only 48% of patients with HR þ BC were treated with endocrine therapy irrespective of the number of metastatic sites or number of organs involved 6 . Moreover, wide variation exists in terms of access to cancer therapies across European countries, with an emphasis on using generic agents first in countries such as Germany and most recently in Belgium.…”

Bendamustine in Metastatic Breast Cancer: An Old Drug in New Design

“…This finding may suggest an alternative therapeutic option with bendamustine against CNS metastases of breast cancer and needs to be further investigated. [33,34].…”