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Japanese Journal of Clinical Oncology Advance Access published online on November 12, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn124
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© The Author (2008). Published by Oxford University Press. All rights reserved

Questionnaire Survey of Treatment Choice for Breast Cancer Patients with Brain Metastasis in Japan: Results of a Nationwide Survey by the Task Force of the Japanese Breast Cancer Society

Koji Matsumoto1, Masashi Ando2, Chikako Yamauchi3, Chiyomi Egawa4, Yasushi Hamamoto5, Masaaki Kataoka5, Takashi Shuto6, Kumiko Karasawa7, Masafumi Kurosumi8, Norimichi Kan9 and Michihide Mitsumori3

1 Hyogo Cancer Center, Division of Medical Oncology, Hyogo
2 National Cancer Center Hospital, Division of Medical Oncology, Tokyo
3 Kyoto University, Department of Therapeutic Radiology and Oncology, Kyoto
4 Kansai Rousai Hospital, Division of Surgery, Hyogo
5 Shikoku Cancer Center Hospital, Division of Therapeutic Radiology, Ehime
6 Yokohama Rousai Hospital, Division of Neurosurgery, Kanagawa
7 Juntendo University, Department of Radiation Oncology, Tokyo
8 Satiama Cancer Center, Division of Pathology, Saitama
9 Hiei Hospital, Division of Surgery, Kyoto, Japan

For reprints and all correspondence: Koji Matsumoto, Hyogo Cancer Center, Division of Medical Oncology, 13-70 Kitaoji-cho, Akashi, Hyogo 673-8558, Japan. E-mail: kojmatsu{at}hp.pref.hyogo.jp

Received May 2, 2008; accepted October 5, 2008

Objective: A nationwide survey was performed to investigate the current patterns of care for brain metastasis (BM) from breast cancer in Japan.

Method: A total of 351 survey questionnaires were sent to community or academic breast oncologists who were members of the Japanese Breast Cancer Society as of December 2005. The questionnaire consists of 40 multiple choice questions in eight categories.

Results: Of 240 institutions sent survey questionnaires, 161 (67.1%) answered; 60% of institutions answered with ‘<5’ patients with BM every year; almost half (83 of 161) screened for BM in asymptomatic patients; surgical resection was rarely performed, as ~75% of institutions (118 of 160 institutions) answered ‘none or one case of surgery per year’; 27% (41 of 154) preferred stereotactic radiosurgery (SRS) over whole-brain radiotherapy (WBRT) as the initial treatment in all cases, although ~70% (100 of 154) of them answered ‘depend on cases’. The preference for SRS over WBRT mainly depends on the impressions of breast oncologists about both safety (late normal tissue damage and dementia in WBRT) and efficacy (better local control by SRS). Eighty-one percent (117 of 144) of institutions did not limit the number of SRS sessions as far as technically applicable.

Conclusion: SRS is widely used as the first choice for BM from breast cancer in Japan. Considerable numbers of Japanese breast oncologists prefer SRS over WBRT as the initial treatment for BM. A randomized trial comparing SRS and WBRT is warranted.

Key Words: breast cancer • brain metastasis • stereotactic radiosurgery • whole-brain radiotherapy


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