Real-World Breast Cancer Patient Follow-Up Practices by Medical Oncologists in India-A Survey Report

Amol Patel; Vineet Govinda Gupta; Bhupesh Guleria; Chandan K Das; Prashant Mehta; Kaushik Mahadevapura Ramegowda

doi:10.1055/s-0041-1739187

Real-World Breast Cancer Patient Follow-Up Practices by Medical Oncologists in India-A Survey Report

South Asian J Cancer. 2022 Feb 5;11(1):9-13. doi: 10.1055/s-0041-1739187. eCollection 2022 Jan.

Authors

Amol Patel¹, Vineet Govinda Gupta², Bhupesh Guleria³, Chandan K Das⁴, Prashant Mehta⁵, Kaushik Mahadevapura Ramegowda⁶

Affiliations

¹ Department of Medicine, Oncology Centre, Indian Naval Hospital Ship, Asvini, Colaba, Mumbai, Maharashtra, India.
² Department of Medical Oncology, Artemis Hospitals, Gurgaon, Haryana, India.
³ Malignant Diseases Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India.
⁴ Department of Medical Oncology, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
⁵ Department of Medical Oncology, Asian Institute of Medical Sciences, Faridabad, Haryana, India.
⁶ Department of Medical Oncology, Malignant Diseases Treatment Centre, Army Hospital Research & Referral, New Delhi, India.

Abstract

Amol PatelBackground In India, breast cancer patients' post-treatment follow-up practices are not known. We did this survey to understand how the breast cancer patients are followed-up and tried to explore the challenges associated with it. Methods We conducted a survey-based study among Indian oncologists. Seven questions were framed pertaining to follow-up practices. Answers were provided in the form of multiple options. Google forms platform was used. Survey was circulated through social media apps and through mail. We sought suggestions and opinions to address the challenges from participants. Results A total of 158 medical oncologists responded to this survey. 10% were not aware that only history and clinical examination are the scientific recommendations for follow-up. Ninety percent of the medical oncologists felt clinical breast examination as an uncomfortable practice for patients and physicians and 39% ordered a chest X-ray and an ultrasound abdomen. Annual mammogram was ordered by 83%, and blood investigations were recommended by 14% routinely. The majority (49.6%) felt that the absence of a female attendant, physician and patient factors were responsible for nonadherence to clinical breast examination. The DEXA scan was recommended by 84 (53%) medical oncologists regularly for patients on aromatase inhibitors, while 23 (14%) did not recommend it. Conclusion There is a disparity between scientific recommendations and real-world follow-up practices. A large number of medical oncologists relied on chest X-ray and ultrasound abdomen. There is an unmet need to address this issue.

Keywords: Breast cancer; Follow-up practices; India; Mammography; Survey.

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