The latest is the greatest? Results of a structured lecture about aromatase inhibitor use for breast cancer

Background. The aromatase inhibitors (AIs) are increasingly surpassing tamoxifen as the endocrine treatment of choice for postmenopausal breast cancer patients. With their increasing use, there is concern that they are being inadvertently prescribed to pre- and peri-menopausal women. Methods. As part of a continuing medical education program for 264 practicing surgeons, a 15-min lecture was given over viewing hormone therapy for early stage breast cancer. Two multi-choice questions were asked before and after the lecture regarding the optimal hormonal treatment for pre and postmenopausal women. Results. For the optimal treatment of premenopausal women, 36% of respondents chose tamoxifen before the lecture, rising to 82% after it (p < 0.01). However 37% suggested an AI would be best, with a further 27% choosing either an AI or tamoxifen, falling to 7% and 11% respectively after the lecture. Before the lecture, 30% of the participants stated that any of the listed treatment options; tamoxifen alone, an AI alone or a combination of tamoxifen and an AI would be acceptable for postmenopausal women. Following the lecture, 53% chose this option (P < 0.01). Conclusions. In many countries it is practicing surgeons who commence endocrine therapy for patients with breast cancer. The findings of this study are useful from two points. Firstly it is clear that many physicians feel that AIs are an effective adjuvant endocrine therapy for premenopausal breast cancer. Secondly it demonstrates the benefits of continuing medical education as a significant improvement in test scores was noted after a structured lecture.