Table 1 Results of the survey.
1. What is the name of your center? | Not disclosed (2 in Basilicata, 10 in Campania, 9 in Puglia) | |
2. How many patients with metastatic BC are treated on average in one year at your center? | 0–50 | 11% |
51–100 | 16% | |
101–150 | 26% | |
≥151 | 47% | |
3. Is there a Pathology Department in your center? | Yes | 95% |
No | 5% | |
4. In the case of metastatic BC, do you consider a tissue biopsy to be: | Mandatory | 63% |
Recommended | 37% | |
Advisable | - | |
Unnecessary | - | |
5. In what percentage of metastatic BC cases do you perform tissue biopsy in your clinical practice? | <10% | 5% |
10–40% | 47% | |
>40% | 47% | |
6. In the case of metastatic BC, when do you perform a tissue biopsy, if clinically feasible? | At the onset of the disease | 68% |
At each progression | 11% | |
At exhaustion of therapeutic lines for that specific molecular subtype | 21% | |
Never | - | |
7. Would you biopsy the metastasis: | In all luminal forms | 47% |
In triple negative | 37% | |
In HER2+ | 16% | |
8. In which molecular subtypes do you consider biopsy unnecessary? | HER2+ | 72% |
Triple negative | 17% | |
Luminal | 11% | |
9. If feasible, at which site would you biopsy BC metastasis? (you can choose more than one option) | Liver | 89% |
Lung | 89% | |
Soft tissues | 89% | |
Brain | 6% | |
Bone | 6% | |
10. In the case of HER2 + disease becoming triple negative, the change of therapeutic lines takes place: | First line | 22% |
Second line | 17% | |
Third line | 17% | |
Never | 44% | |
11. Do you discuss metastatic cancer cases in the multidisciplinary team? | Yes | 44% |
Only in the event of treatment of selected cases | 50% | |
No | 6% | |
12. Do you report to the pathologist the necessary information on the receptor status of the primary metastatic tumour? | Yes | 89% |
Only in the event of treatment of selected cases | 11% | |
No | - | |
13. Do you use the liquid biopsy procedure in your clinical practice? | Yes | 22% |
Sometimes | 50% | |
No | 22% | |
14. Which genes do you consider essential to study in the liquid biopsy (you can choose more than one option): | PIK3CA | 100% |
ESR1 | 89% | |
BRCA 1/2 | 44% | |
TP53 | 6% | |
15. How much does patient preference weigh on the recommendation of metastasis biopsy? | Much | 44% |
Little | 39% | |
None | 17% | |
16. How much time do you spend explaining the risks and benefits of the diagnostic procedure to patients? | 10 min | 33% |
11–20 min | 61% | |
21–30 min | 6% | |
17. Do you consider the management of metastatic BC according to current guidelines and diagnostic and therapeutic care pathways (PDTA) to be sustainable in your practice? | Yes We do it regularly Derived from scientific evidence In order to be protected from the medical-legal point of view (unfortunately) In order to share the treatment pathway within the multidisciplinary team Each case is discussed in the multidisciplinary team and each specialist takes charge of the patient I personally worked on the drafting of the PDTA and apply the guidelines Because all the figures are there to manage the diagnostic process Good supporting multidisciplinary team Availability of sufficient resources to implement the PDTA A multidisciplinary approach has long existed in our center Not to go outside the guidelines and be prosecuted criminally | 78% |
Sometimes Timing is not always easy to meet, in some realities pathology and radiology are in great difficulty and often late in giving adequate answers Timing of diagnosis (especially biological-molecular); Unavailability of liquid biopsy | 17% | |
No Because of the timing of the pathway, the complexity of the investigations and sustainability | 51% |
