Physician's knowledge, attitudes and practice pattern for breast cancer diagnosed during pregnancy: a survey among breast care specialists in Japan

Breast Cancer. 2020 Sep;27(5):796-802. doi: 10.1007/s12282-020-01118-8. Epub 2020 Jun 26.

Abstract

Background: Breast cancer diagnosed during pregnancy (BCP) is uncommon, and thus there is limited evidence on its treatment. However, the incidence of BCP is increasing probably due to women having children at an older age. We aimed to clarify the practice patterns and limitations in treatment for BCP in Japan.

Methods: A cross-sectional survey was developed for board-certified Japanese breast cancer specialists (n = 1583) to evaluate their knowledge, attitude, experience, and practice patterns regarding BCP. Survey items also included questions regarding potential barriers of practice toward patients diagnosed during pregnancy and respondents' background.

Results: In March 2018, 492 (31.1%) breast oncologists responded to the survey. Among them, 234 (48%) respondents had the experience of treating at least one case of BCP. The accuracy of knowledge about BCP was evaluated by three items regarding BCP treatment from the latest Japanese Breast Cancer Society treatment guideline, and 265 (54%) were categorized to have "appropriate knowledge". Majority of the physicians (89%) have responded that patients should be treated in a center where both a cancer-treating team and obstetrician exist, and 48% responded that treating patients by the collaboration of cancer-treating team and obstetric team in different institutes is an alternative reasonable option.

Conclusions: Interest, knowledge, and awareness of the guidelines appear to influence physician attitude, and thus it is urgently important to lay out educational materials and learning opportunities regarding BCP for breast specialists. A regional network of oncologists, obstetricians, and pediatricians to support the BCP patients should be developed.

Keywords: Breast cancer during pregnancy; Obstetricians; Pediatricians; Survey.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / therapy
  • Clinical Competence / standards
  • Clinical Competence / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Japan
  • Middle Aged
  • Obstetrics / standards
  • Obstetrics / statistics & numerical data
  • Oncologists / standards
  • Oncologists / statistics & numerical data
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Pregnancy
  • Pregnancy Complications, Neoplastic / diagnosis*
  • Pregnancy Complications, Neoplastic / therapy
  • Surveys and Questionnaires / statistics & numerical data