The MARECA (national study of management of breast cancer locoregional recurrence and oncological outcomes) study: National practice questionnaire of United Kingdom multi-disciplinary decision making

This national practice questionnaire (NPQ) was designed to establish the current practice of UK breast multidisciplinary teams (MDTs) regarding breast cancer locoregional recurrence (LRR) management. Scenario-based questions were used to elicit preference in pre-operative staging investigations, surgical management, and adjuvant therapy. In total, 822 MDT members across 42 breast units participated in the NPQ (Feb-Aug 2021). Most units (95%) routinely performed staging CT scan, but bone scan was selectively performed (31%). For patients treated with BCS and radiotherapy, few units (7%) always/usually offered repeat BCS. In the absence of radiotherapy, most units (90%) always/usually offered repeat BCS. For patients presenting with local recurrence following previous BCS and SLNB, most units (95%) advocated repeat SLNB. Where SLNs could not be identified, 86% proceeded to a four-node axillary sampling procedure. For ER+HER2- node negative LRR, 10% of units always/usually offered chemotherapy. For ER+HER2- node positive LRR, this recommendation increased to 64%. For triple negative LRR, 90% of units always/usually offered chemotherapy. Further research is required to determine how these management patterns influence patient outcomes, which will refine optimal treatment pathways.

Classifications: Breast Cancer Treatment

Keywords: Local recurrence Trials