Patterns of care study in Japan: Analysis of patients subjected to mastectomy followed by radiotherapy

Naoto Shikama, Shigeru Sasaki, Michihide Mitsumori, Masahiro Hiraoka, Chikako Yamauchi, Tokihiro Yamamoto, Teruki Teshima, Toshihiko Inoue

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Two prospective studies reported in 1997 demonstrated that postoperative radiotherapy after mastectomy was not only associated with a higher loco-regional control rate but also with a higher overall survival rate. The purpose of this study is to clarify the processes of care for patients undergoing mastectomy and postoperative radiotherapy in Japan. Methods: A national survey carried out in 1998-2000, involving 79 Japanese institutions by two-stage cluster sampling of institutions and patients, disclosed that 1124 patients with breast cancer had been treated between 1995 and 1997. Mastectomy followed by radiotherapy was performed on 258 patients. Results: The compliance rates for pre-treatment evaluation, including history, physical examination and mammography, averaged ∼50% (24-81%). The chest wall was irradiated in only 19% of the patients and regional node irradiation was carried out for 70-86%. Radiation treatment planning with the aid of computed tomography was done in only 29% of patients (university hospitals or cancer centers, 39%; other hospitals, 17%; P = 0.001). Hormonal therapy was administered to 56% of the patients who showed no endocrine responsiveness. Non-intensive chemotherapy, which did not include the use of anthracycline or taxol, was used in 55% of the patients who received chemotherapy. Conclusions: There is room for improvement regarding some aspects of radiotherapy and adjuvant systemic therapies. Especially in the field of radiotherapy, significant differences were found among the treatment techniques employed in various institutions.

Original languageEnglish (US)
Pages (from-to)456-462
Number of pages7
JournalJapanese Journal of Clinical Oncology
Issue number9
StatePublished - Sep 1 2003
Externally publishedYes


  • Breast cancer
  • Mastectomy
  • Patterns of care study
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology


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