Abstract P5-15-02: The risk for locoregional breast cancer recurrences: Significant differences in perceptions among health care professionals (HCPs)
Authors: Ankersmid Jet W. , Spronk Pauline E.R. , Zeillemaker Anneke M. , Siesling Sabine 
Published: March 2022

Abstract
Introduction: Unlike the highly personalized breast cancer treatment, surveillance in the Netherlands is still ‘one-size-fits-all’: annual imaging and physical examination for at least five year after treatment. To identify patients with a low or high risk for locoregional recurrences (LRRs) who might benefit from less or more intensive surveillance, risk prediction models can be used. The INFLUENCE-nomogram is an example of this and is developed using on data of the Netherlands Cancer Registry. It remains unclear to which extent health care professionals (HCPs) are able to accurately estimate the patient individual risk for locoregional recurrences. Objective: To evaluate the current awareness, knowledge and ability to estimate patients individual risks for locoregional recurrences after breast cancer - without using any prediction tools - among HCPs in the Netherlands. Methods: In this study, a cross-sectional survey was performed among general practitioners (GPs) and HCPs working in breast cancer care in six teaching hospitals in the Netherlands. In total, 85 HCPs (25 GPs and 60 hospital HCPs) participated. HCPs received descriptions of eleven breast cancer cases with different patient-, tumor- and treatment characteristics for which they were asked to estimate the risk for LRRs. The estimations were compared among different groups of HCPs and with the estimation calculated using the INFLUENCE-nomogram. Results: HCPs structurally overestimated the risk for LRRs (ranging from an average overestimation from 4% on one case to 26% on another case). In nine out of eleven cases, significant differences in risk estimates were found between groups of HCPs. In five of the eleven cases, GPs had a significantly higher median estimate than medical oncologists (respectively 10 % vs. 2.5 %; 15 % vs. 5 %; 25 % vs. 6.5 %; 25% vs. 6.5 %; 8 % vs. 1 %; and 12 % vs. 2% on these five cases). Conclusion: The structural overestimation of the risks stresses the importance to create more awareness and knowledge of the risk for LRRs after breast cancer. Medical oncologists seem to estimates risks for recurrences more accurately then GPs. This might be due to the fact that medical oncologists have more experience with the use of risk prediction models (such as Predict) in clinical practice. More awareness and knowledge of the risk for LRRs can be generated using objective estimations by prediction models. This will support the implementation of personalized surveillance after breast cancer.
Table: Descriptive statistics predicted five-year risks HCPs and risk estimation INFLUENCE-nomogramCaseNMin.Max.MedianMeanStd. DeviationVarianceRisk estimation INFLUENCE-nomogramAverage overestimation HCPs1a850305***5.805.3028.040.96 %4.84 %1b850708***10.6410.07101.312.29 %8.35 %28536015***17.6712.16147.847.17 %10.50 %3a850305***6.956.8046.231.18 %5.77 %3b850.17010***12.5310.70114.482.27 %10.26 %4a8515010***12.598.3769.980.74 %11.85 %4b850.58019***19.0612.86165.441.72 %17.34 %5a851.56020***20.5713.38179.041.57 %19.00 %5b842.59025***29.6818.70349.783.6 %26.08 %6a630305***7.216.1137.310.64 %6.57 %6b620.14010***11.909.1884.272.94 %8.96 %Results of Wilcoxon one-sample signed rank test *** Median is significantly greater than risk estimation INFLUENCE-nomogram at the 0.001 level. ** Median is significantly greater than risk estimation INFLUENCE-nomogram at the 0.01 level. * Median is significantly greater than risk estimation INFLUENCE-nomogram at the 0.05 level.
Citation Format: Jet W. Ankersmid, Pauline E.R. Spronk, Anneke M. Zeillemaker, Sabine Siesling. The risk for locoregional breast cancer recurrences: Significant differences in perceptions among health care professionals (HCPs) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-15-02.