Agreement on risk assessment and chemotherapy recommendations among breast cancer specialists: A survey within the MINDACT cohort
Josephine M.N. Lopes Cardozo,
Sherylene E. Veira,
Laila Ait Hassou,
Aimé Lambert Uwimana,
Ivana Božović-Spasojević,
Jan Bogaerts,
Fatima Cardoso,
Marjanka K. Schmidt,
Emiel J.T. Rutgers,
Coralie Poncet,
Caroline A. Drukker
Affiliations
Josephine M.N. Lopes Cardozo
Department of Surgical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue Emmanuel Mounier 83/11, 1200, Brussels, Belgium
Sherylene E. Veira
Department of Surgical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands
Laila Ait Hassou
European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue Emmanuel Mounier 83/11, 1200, Brussels, Belgium
Aimé Lambert Uwimana
European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue Emmanuel Mounier 83/11, 1200, Brussels, Belgium
Ivana Božović-Spasojević
Institute for Oncology and Radiology of Serbia, Pasterova 14, 11000, Belgrade, Serbia
Jan Bogaerts
European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue Emmanuel Mounier 83/11, 1200, Brussels, Belgium
Fatima Cardoso
Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Av. Brasília, 1400-038, Lisbon, Portugal
Marjanka K. Schmidt
Department of Molecular Pathology and Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands
Emiel J.T. Rutgers
Department of Surgical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands
Coralie Poncet
European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue Emmanuel Mounier 83/11, 1200, Brussels, Belgium
Caroline A. Drukker
Department of Surgical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands; Corresponding author.
Purpose: Tailored recommendation for adjuvant chemotherapy in breast cancer patients is of great importance. This survey assessed agreement among oncologists on risk assessment and chemotherapy recommendation, the impact of adding the 70-gene signature to clinical-pathological characteristics, and changes over time. Methods: A survey consisting of 37 discordant patient cases from the MINDACT trial (T1-3N0-1M0) was sent to European breast cancer specialists for assessment of risk (high or low) and chemotherapy administration (yes or no). In 2015 the survey was sent twice (survey 1 and 2), several weeks apart, and in 2021 a third time (survey 3). Only the second and third surveys included the 70-gene signature result. Results: 41 breast cancer specialists participated in all three surveys. Overall agreement between respondents decreased slightly between survey 1 and 2, but increased again in survey 3. Over time there was an increase in agreement with the 70-gene signature result on risk assessment, 23% in survey 2 versus 1 and 11% in survey 3 versus 2. With information available indicating a low risk 70-gene signature (n = 25 cases), 20% of risk assessments changed from high to low and 19% of recommendations changed from yes to no chemotherapy in survey 2 versus 1, further increasing with 18% and 21%, respectively, in survey 3 versus 2. Conclusion: There is a variability in risk assessment of early breast cancer patients among breast cancer specialists. The 70-gene signature provided valuable information, resulting in fewer patients being assessed as high risk and fewer recommendations for chemotherapy, increasing over time.
