Wardley A - Overall, distress levels were higher at recurrence than at first diagnosis of early breast cancer for both patients and physicians and the goal of treatment for this disease stage was to improve the patient's quality of life, delay disease progression and improve overall survival. While most respondents (96%) use the currently available guidelines, improvements are required, including the development of uniform global guidelines and recommendations for specific patient groups. Interactive computer programs and e-mail updates should also be utilised to ensure physicians are able to make fully informed decisions regarding optimum treatment.