Assessment of Chemotherapy Knowledge and Practices Among Breast Surgeons in India: Identifying Gaps and Areas for Improvement.

Abstract

This cross-sectional survey aimed to assess the knowledge and current practice of chemotherapy among breast surgeons in India. The objective was to evaluate their familiarity with chemotherapy protocols, treatment preferences, and utilisation of emerging technologies to identify areas for improvement and potential gaps in the delivery of breast cancer care. The survey employed a questionnaire-based approach using the Google Forms platform. A total of 264 breast surgeons actively involved in the clinical management of breast cancer participated in the study. The questionnaire consisted of 19 closed-ended questions covering various aspects of breast cancer management. The survey was distributed to participants via WhatsApp or email. The survey involved 264 surgeons, 60.6% employed at a cancer centre and 27.2% at a teaching hospital. A total of 43.1% reported routinely administering chemotherapy to patients with breast cancer, 32.8% took a selective approach, and 24.1% had never administered chemotherapy to breast cancer patients. In addition, 39.7% consistently discussed cases in a multidisciplinary team (MDT) setting, 24.8% preferred MDT discussions but not on every occasion, and 35.5% did not have access to an MDT. Regarding central venous access device (CVAD) utilisation, 10.3% always used CVADs, 67.2% used them selectively, and 22.4% did not routinely employ CVADs. Furthermore, 96.6% of respondents consistently inquired about molecular subtypes, while 53.4% advised patients about genetic testing. For management strategies, 86.2% considered NACT for selected EBC patients. The sandwich protocol was used for large operable breast cancer by 53.4%, and 58.6% used it for LABC. Only 36.2% considered SLNB in post-NACT cases, while 11.7% performed SLNB in this setting. These findings highlight the need for continued research, professional development training, consensus-building, and adherence to evidence-based guidelines to ensure optimal and standardised care for breast cancer patients in India.