DCIS management since publication of clinical practice recommendations: surgeons' practices and women's experiences

乳腺导管原位癌（DCIS）现在占所有新发乳腺癌病例的15%。虽然是一种良性疾病，但它的诊断增加了妇女患浸润性乳腺癌的风险，治疗的目标是预防浸润性疾病。然而，预测这一进展的特征尚未被清楚地确定。因此，妇女对自己的诊断感到困惑，临床医生和妇女都面临着复杂的治疗决定。国家乳腺癌中心（NBCC）于2003年9月发布了一套关于DCIS管理的八项临床实践建议，并于2004年发布了一份消费者指南。目前没有关于外科医生如何接受治疗建议的信息，DCIS的管理现在遵循这些建议的程度或治疗建议对DCIS妇女医疗经历的影响的信息。这个项目将填补这一空白。该项目旨在：1.；检查乳腺导管原位癌（DCIS）治疗的临床实践建议对临床实践的影响2。确定外科医生对DCIS建议的认识和态度，并检查这些态度与临床实践之间的关系3。在2004年消费者指南发布后，调查妇女接受DCIS诊断的经历、她们对预后的理解以及她们参与治疗决策的情况。这项研究将确定2003年发表的治疗建议是否影响了DCIS妇女接受的医疗护理，并确定与外科医生和妇女有关的促进或阻止接受这些建议的因素。这些信息将用于制定策略，增加外科医生对治疗建议的采用，以确保所有患有DCIS的妇女都能获得尽可能最好的治疗。

Ductal Carcinoma in Situ of the breast (DCIS) now represents 15% of all new cases of breast cancer. Although a benign disease, its diagnosis increases a woman's risk of developing invasive breast cancer and the goal of treatment is prevention of invasive disease. However the characteristics that predict this progression have not been clearly identified. Consequently women are confused about their diagnosis and both clinicians and women are faced with complex treatment decisions. The National Breast Cancer Centre (NBCC) published a set of eight clinical practice recommendations for the management of DCIS in September 2003 and a guide for consumers in 2004. Currently there is no information regarding how the treatment recommendations have been received by surgeons, the extent management of DCIS now follows these recommendations or the impact of the treatment recommendations on the medical experiences of women with DCIS. This project will fill this gap. The project aims to: 1. Examine the impact of clinical practice recommendations for the management of Ductal Carcinoma in Situ (DCIS) of the breast on clinical practice 2. Determine awareness of and attitudes towards the recommendations among surgeons treating DCIS and to examine the relationship between these attitudes and clinical practice 3. Examine women's experience of a DCIS diagnosis, their understanding of its prognosis and involvement in treatment decisions after release of a consumer guide in 2004 This research will determine whether the publication of the treatment recommendations in 2003 influenced the medical care women with DCIS recieve and identify the factors associated with surgeons and women that facilitate or prevent the uptake of these recommendations. This information will be used to develop strategies increase surgeons' adoption of the treatment recommendations in order to ensure that all women with DCIS have access to the best care possible.