Editor’s Note:

The management of patients with breast cancer has always been fraught with challenging decisions. For more than two decades, physicians and patients have struggled with choices in breast conservation, and the emergence of sentinel node biopsy, new adjuvant endocrine therapies, chemoprevention strategies and neoadjuvant regimens has made these decisions even more complex.

The Miami Breast Cancer Conference – now in its 19th year under the direction of Dr Daniel Osman – has always addressed these controversies directly. For years, using electronic keypad polling, we have posed management questions about clinical scenarios and compared answers from attendees and faculty members.

For our 2002 meeting, we took this process to a new level and obtained an unrestricted educational grant to allow a nationally recognized polling firm, ReedHaldyMcIntosh, to survey 200 randomly selected medical oncologists and surgeons in December 2001 about dozens of controversial breast cancer management issues, which included many specific case scenarios.

This issue of Breast Cancer Update documents key results from this survey and answers to the interactive questions posed to the Miami Breast Cancer Conference (MBCC) attendees. The comprehensive results are available on the BreastCancerUpdate.com website. It is interesting to compare the responses from the physicians in this national survey to those attending the conference, who by their presence at a three-day breast cancer meeting are presumably more focused on breast cancer in their practices.

When one considers the enormous investment in breast cancer clinical research, it is surprising how little attention is committed to defining whether these advances are being actualized in clinical practice. In part, this survey was intended to stimulate discussion on precisely that issue.

— Neil Love, MD

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