Article
Comparison of International Breast Cancer Guidelines – Where do the National Guidelines differ in Treatment Recommendations?
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Authors
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A. Wöckel
- University Hospital -Department of Gynecology and Obstetrics, Ulm, Germany
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R. Wolters
- University Bremen - E-Science-Institute, Bremen, Germany
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L. Schwentner
- University Hospital -Department of Gynecology and Obstetrics, Ulm, Germany
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M. Wischnewsky
- University Bremen - E-Science-Institute, Bremen, Germany
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R. Kreienberg
- University Hospital -Department of Gynecology and Obstetrics, Ulm, Germany
| Published: | July 10, 2012 |
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Outline
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Introduction: Numerous Clinical practice guidelines (CPGs) for the diagnosis and treatment of breast cancer have been developed by different national health institutions or medical societies. While a comparison of methodological criteria has been undertaken before, it is unknown whether these CPGs differ in their actual treatment recommendations.
Methods: We included breast cancer CPGs from the USA (NCCN, ASCO), Canada (CCO), Australia (NBOCC), the UK (NICE, SIGN), and Germany (DKG) that satisfy internationally recognized methodological criteria and are in widespread use in daily clinical care. Treatment recommendations for adjuvant invasive breast cancer including surgery, radiation, endocrine therapy, chemotherapy, and anti-HER2-therapy were compared.
Results: Most treatment recommendations exhibit a large degree of congruency. This reflects the fact that they rest on the same evidence base, and that many national guidelines are adopted from other guidelines so that well accepted guidelines are cited within other guidelines.
Concluding statement: Considering that the development of guidelines is a very expensive and resource-intensive task the question arises whether the development of national guidelines in numerous countries is worth the effort since the recommendations differ only marginally.
