Table 2 Agreement between the panelists and the SBM affiliated breast surgeons for the questions related to surgical treatment
Question | Panelists before brainstorming | Affiliated breast surgeons | ||
|---|---|---|---|---|
Disagreement n (%) | Agreement n (%) | Disagreement n (%) | Agreement n (%) | |
Q07. If the axilla is clinically positive, neoadjuvant chemotherapy should be recommended. | 0 (0.0) | 27 (100.0) | 7 (3.3) | 207 (96.7) |
Q08. If the axilla is clinically negative, when conservative treatment is possible, neoadjuvant chemotherapy should be recommended for tumors > 1.0 cm. | 10 (37.0) | 17 (63.0) | 98 (45.8) | 116 (54.2) |
Q09. Following BCS and when the SLN is positive at upfront surgery, in addition to systemic treatment, radiotherapy should be recommended as local treatment. | 5 (18.5) | 22 (81.5) | 58 (27.1) | 156 (72.9) |
Q10. Following mastectomy and when the SLN is positive at upfront surgery, in addition to systemic treatment, radiotherapy should be recommended as local treatment. | 5 (18.5) | 22 (81.5) | 95 (44.4) | 119 (55.6) |
Q11. If the SLN is positive following neoadjuvant therapy, ALND should be recommended. | 4 (14.8) | 23 (85.2) | 35 (16.4) | 179 (83.6) |
Q12. If the axilla is initially positive, some form of lymph node marking should be recommended prior to neoadjuvant therapy. | 19 (70.4) | 8 (29.6) | 113 (52.8) | 101 (47.2) |
Q13. In patients with positive axilla who achieve complete clinical response to neoadjuvant therapy with negative SLN not previously marked, ALND should be recommended in all cases. | 26 (96.3) | 1 (3.7) | 196 (91.6) | 18 (8.4) |
Q14. If germline genetic testing is negative, bilateral mastectomy should be recommended. | 27 (100.0) | 0 (0.0) | 207 (96.7) | 7 (3.3) |
Q16. If germline genetic testing is negative, the patient’s family history should be considered when recommending bilateral mastectomy. | 7 (25.9) | 20 (74.1) | 73 (34.1) | 141 (65.9) |
Q17. If testing for high-penetrance gene mutations is positive, the possibility of bilateral mastectomy should be considered. | 0 (0.0) | 27 (100.0) | 4 (1.9) | 210 (98.1) |
Q19. If the NAC is disease-free and testing for high-penetrance gene mutations is positive, nipple-sparing mastectomy should be recommended. | 0 (0.0) | 27 (100.0) | 5 (2.3) | 209 (97.7) |
Q27. If testing for high-penetrance gene mutations is positive, BCS should be considered sufficient. | 17 (63.0) | 10 (37.0) | 129 (60.3) | 85 (39.7) |