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Japanese Journal of Clinical Oncology Advance Access published online on October 2, 2007
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hym096
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© 2007 Foundation for Promotion of Cancer Research

Patterns of Care Study of Breast-conserving Therapy in Japan: Comparison of the Treatment Process between 1995–1997 and 1999–2001 Surveys

Chikako Yamauchi1,2,, Michihide Mitsumori1,2, Heitetsu Sai1,2, Toshiyuki Imagunbai1,2, Yoshiharu Negoro1,2, Yoshihide Sasaki1,2, Masahiro Hiraoka1,2, Naoto Shikama1,3, Shigeru Sasaki1,3, Hideki Takegawa1,4, Toshihiko Inoue1,5 and Teruki Teshima1,4

1 Japanese PCS Working Subgroup of Breast Cancer
2 Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto
3 Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Nagano
4 Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka
5 Department of Radiation Oncology Osaka University Graduate School of Medicine, Suita, Osaka, Japan

For reprints and all correspondence: Chikako Yamauchi, Department of Radiation Oncology and Image-applied Therapy Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan; E-mail: chikay{at}kuhp.kyoto-u.ac.jp

Received January 26, 2007; accepted June 8, 2007

Background: The Japan Patterns of Care Study (JPCS) conducted two national surveys to identify changes associated with the treatment process of care for patients undergoing breast-conserving therapy (BCT). Between the two national surveys, the Japanese Breast Cancer Society published its treatment guideline for BCT.

Method: The first survey collected data on 865 patients treated between 1995 and 1997 (JPCS-1), and the second on 746 patients treated between1999 and 2001 (JPCS-2) by extramural audits.

Results: There was a shift to an older age distribution in JPCS-2 compared with JPCS-1. In JPCS-2, the average patient age was 53.9 compared with 51.5 in JPCS-1 (P < 0.001). There was a reduction in the extent of breast surgery and the proportion of the patients who received quadrantectomy was 57.0% in JPCS-1 and 30.3% in JPCS-2 (P < 0.001). In JPCS-2, a cast or shell for immobilization was used at a significantly higher rate of 52.9% compared with 32.6% for JPCS-1 (P < 0.001). The rate of boost irradiation was increased in JPCS-2, especially for patients with a positive surgical margin; it was significantly increased to 83.5% in JPCS-2 compared with 53.9% in JPCS-1 (P < 0.001).

Conclusions: The second survey revealed a rapid change in the trend of the treatment of BCT in Japan and represented high compliance of the treatment guideline for BCT published by the Japanese Breast Cancer Society (JBCS) in 1999.

Key Words: patterns of care study • breast cancer • breast conserving-therapy • radiation therapy


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