Evidence map›Paper›PMID 32971350›Full record

ArticleBreast (Edinburgh, Scotland)2020

Views of healthcare professionals about the role of active monitoring in the management of ductal carcinoma in situ (DCIS): Qualitative interview study.

Brooke Nickel, Kirsten McCaffery, Nehmat Houssami, Jesse Jansen, Christobel Saunders, Andrew Spillane, Claudia Rutherford, Ann Dixon, Alexandra Barratt, Kirsty Stuart and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Breast (Edinburgh, Scotland), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Should low-risk DCIS lose the cancer label? An evidence review.Breast cancer research and treatment · 2023
    Review
  6. Article
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 3 countries.

Brooke NickelWiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Kirsten McCafferyWiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Nehmat HoussamiWiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Jesse JansenWiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
Christobel SaundersSchool of Medicine, University of Western Australia, Perth, WA, Australia.
Andrew SpillaneThe University of Sydney, Northern Clinical School, St Leonards, NSW, Australia; Mater Hospital, Wollstonecraft, NSW, Australia; Royal North Shore Hospital, St Leonards, NSW, Australia.
Claudia RutherfordThe University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW, Australia; The University of Sydney, Faculty Medicine and Health, Sydney Nursing School, Sydney, NSW, Australia.
Ann DixonWiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Alexandra BarrattWiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Kirsty StuartDepartment of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead, NSW, Australia; Westmead Breast Cancer Institute, Westmead, NSW, Australia; Western Clinical School, The University of Sydney, NSW, Australia.
Geraldine RobertsonBreast Cancer Network Australia, VIC, Australia.
Jolyn HerschWiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia. Electronic address: jolyn.hersch@sydney.edu.au.
The University of Sydney · AUBreast Cancer Network Australia · AUThe University of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuctal carcinoma in situ (DCIS) is an in-situ (pre-cancerous) breast malignancy whereby malignant cells are contained within the basement membrane of the breast ducts. Increasing awareness that some low-risk forms of DCIS might remain indolent for many years has led to concern about overtreatment, with at least 3 clinical trials underway internationally assessing the safety of active monitoring for low-risk DCIS. This study aimed to understand healthcare professionals' (HCPs) views on the management options for patients with DCIS.

methodsQualitative study using semi-structured interviews with HCPs involved in the diagnosis and management of DCIS in Australia and New Zealand. Interviews were audio-recorded, transcribed and analysed thematically using Framework Analysis method.

resultsTwenty-six HCPs including 10 breast surgeons, 3 breast physicians, 6 radiation oncologists, and 7 breast care nurses participated. There was a strong overall consensus that DCIS requires active treatment. HCPs generally felt uncomfortable recommending active monitoring as a management option for low-risk DCIS as they viewed this as outside current standard care. Overall, HCPs felt that active monitoring was an unproven strategy in need of an evidence base; however, many acknowledged that active monitoring for low-risk DCIS could be appropriate for patients with significant co-morbidities or limited life expectancy. They believed that most patients would opt for surgery wherever possible.

conclusionsThis study highlights the important need for robust randomised controlled trial data about active monitoring for women with low-risk DCIS, to provide HCPs with confidence in their management recommendations and decision-making.

Indexed as

Attitude of Health PersonnelWatchful WaitingAdultAustraliaBreast NeoplasmsCarcinoma, Intraductal, NoninfiltratingFemaleHealth PersonnelHumansMaleMedical OveruseMiddle AgedNew ZealandNursesPhysiciansProfessional-Patient RelationsActive monitoringDuctal carcinoma in situManagementOvertreatmentQualitative

Identifiers

PMID32971350
PMCPMC7509786
OpenAlexW3086128562

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.