As early as 2001, several randomized trials demonstrated that adjuvant aromatase inhibitor treatment is superior to tamoxifen for decreasing breast cancer recurrence among women with estrogen receptor positive breast cancer. CRN investigators used automated pharmacy data from seven CRN sites to assess the use of aromatase inhibitors and tamoxifen between 1996 and 2003. This study, co-led by Dr. Edward Wagner (GHC) and Ms. Erin Aiello Bowles (GHC), also included an oncologist survey to assess whether and how CRN organizations and oncology groups made policy decisions about cancer interventions. Aromatase inhibitor use rose dramatically after 2001, while tamoxifen use decreased. Regardless of whether their site had formal treatment guidelines, almost all oncologists reported prescribing aromatase inhibitors under various circumstances: metastatic breast cancer, after completion of tamoxifen, or in lieu of tamoxifen.
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