297P - Professional attitudes towards treatment of rare histological subtypes of carcinomas of the breast: an international practice survey (PARIS study)

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Breast Cancer, Early Stage
Presenter zouhour Fadoukhair
Authors Z. Fadoukhair1, D. Lefeuvre2, K. Hofert3, E. Lanoy2, R. Rahhali4, M. Mathieu5, C. Mazouni6, S. Delaloge7
  • 1Medical Oncology, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 2Biosatitistics, Gustave Roussy, 94805 - villejuif/FR
  • 3Medical Oncology, University of liverpool, L3 - liverpool/UK
  • 4Medical Oncology, National Institute of Oncology, 10100 - Rabat/MA
  • 5Department Of Pathology, Institut Gustave Roussy, Villejuif/FR
  • 6Breast Cancer Unit, Department Of Surgery, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 7Breast Cancer Unit, Department Of Medical Oncology, Institut Gustave Roussy, 94805 - Villejuif/FR



WHO classification has identified a dozen rare subtypes that account for less than 10% of all breast cancers (BC). They are generally not taken into account in international/national treatment (trt) guidelines. We evaluated professionals' attitudes towards decision making regarding rare BC subtypes and their need for consensus guidelines.


This international survey was conducted among 236 international BC experts including surgeons, pathologists, medical oncologists and radiation oncologists. Experts were chosen to be representative of all regions of the world. They were selected if part of regional, national or international BC guidelines committee(s), or active member of a BC-directed scientific society, or author > 50 publications in the field of BC. They were contacted through email up to three times and were asked to fill an online questionnaire.


86 experts from 32 countries responded (36%). A total of 50% were medical oncologists, 21% surgeons, 17% pathologists and 12% radiation oncologists. 77% of the experts declared they based their general BC care decisions on regional, national or international guidelines. Up to 76% declared individual routine trt decisions for BC were taken by multi-disciplinary boards in their practice. However, only 10% strongly considered rare BC should be treated following national or international guidelines without specific individualisation. Interestingly, 50-80% described individualising treatment for rare breast cancers according to pathological subtype of the tumour in their practice. Three specific clinical situations of rare BC presented were associated with > 50% heterogeneity in trt decision among the 86 experts. Answers were associated with both region of residency and medical subspecialty. However, more than 90% of experts answered they would welcome international recommendations for rare BC subtypes.


Rare BC subtypes are diagnosed and managed very heterogeneously depending on geographical location, habits and specialist training of medical professionals. There is need for international consensus guidelines regarding their diagnosis and trt.


All authors have declared no conflicts of interest.