The Approach of General Surgeons to Oncoplastic and Reconstructive Breast Surgery in Turkey: A Survey of Practice Patterns

Year 2014, Volume: 31 Issue: 4, 307 - 312, 01.10.2014

Mustafa Emiroğlu Cem Karaali Cengiz Aydın İsmail Sert Varlık Erol Abdullah İnal Kemal Peker Enver İlhan Hilmi Güngör Mehmet Ali Gülçelik Didem Can

Abstract

Background: Oncoplastic Breast Surgery (OBS), which is a combination of oncological procedures and plastic surgery techniques, has recently gained widespread use. Aims: To assess the experiences, practice patterns and preferred approaches to Oncoplastic and Reconstructive Breast Surgery (ORBS) undertaken by general surgeons specializing in breast surgery in Turkey. Study Design: Cross-sectional study. Methods: Between December 2013 and February 2014, an eleven-question survey was distributed among 208 general surgeons specializing in breast surgery. The questions focused on the attitudes of general surgeons toward performing oncoplastic breast surgery (OBS), the role of the general surgeon in OBS and their training for it as well as their approaches to evaluating cosmetic outcomes in Breast Conserving Surgery (BCS) and informing patients about ORBS preoperatively. Results: Responses from all 208 surgeons indicated that 79.8% evaluated the cosmetic outcomes of BCS, while 94.2% informed their patients preoperatively about ORBS. 52.5% performed BCS (31.3% themselves, 21.1% together with a plastic surgeon). 53.8% emphasized that general surgeons should carry out OBS themselves. 36.1% of respondents suggested that OBS training should be included within mainstream surgical training, whereas 27.4% believed this training should be conducted by specialised centres. Conclusion: Although OBS procedure rates are low in Turkey, it is encouraging to see general surgeons practicing ORBS themselves. The survey demonstrates that our general surgeons aspire to learn and utilize OBS techniques.

Keywords

General surgeon, oncoplastic breast surgery, survey

References

• 1. Fisher B, Redmond C, Fisher ER, Bauer M, Wolmark N, Wickerham DL, et al. Ten years results of randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation. N Engl J Med 1985;312:674-81. [CrossRef]
• 2. Losken A, Dugal CS, Styblo TM, Carlson. A meta-analysis comparing breast conservation therapy alone to the oncoplastic technique. Ann Plast Surg 2014;72:145-9. [CrossRef]
• 3. Down SK,Jha PK,Burger A,Hussien MI. Oncological advantages of oncoplastic breast-conserving surgery in treatment of early breast cancer. Breast J 2013;19:56-63. [CrossRef]
• 4. Haydaroğlu A. 1. National Consensus of the Breast Cancer, İzmir: Congress printing office; 2007:63-8.
• 5. Gwack G, Lee HK, Kim HJ, Lee SY, Park YL, Lee JW. Survey of the application of the Korea clinical practice recommendations on Breast cancer treatment: Utility of the Korean Breast Cancer Society Guidelines. J Breast Cancer 2012;15:239-43. [CrossRef]
• 6. Cantürk NZ, Gulluoglu MB. Differences in breast cancer diagnosis and surgical treatment among Turkish Univeristy Hospitals. J Breast Health 2011;4:207-15.
• 7. Emiroğlu M, Inal A, Sert I, Ilhan E, Peker K, Gürçelik MA, et al. How do surgeons approach breast cancer surgery in Turkey? A national survey. Breast Cancer 2013 Oct 13. [Epub ahead of print] (DOI:10.1007/ s12282-013-0500-4)
• 8. Morrow M. 13 th St. Gallen IBCC; 2013.
• 9. Andree C, Farhadi J, Goossens D, Masia J, Sarfati I, Germann G, et al. A position statement on optimizing the role of oncoplastic breast surgery. E Plasty 2012;12:e40.
• 10. Tuncer M. Significance of cancer in Turkey, the burden of disease and cancer control policies. In: Tuncer M. Cancer control in Turkey. Ankara: Onur Press, Ministry of Health Publication; 2008:5-9.
• 11. Malycha PL, Gough IR, Margaritoni M, Deo SV, Sandalin K, Buccimazza I, et al. Oncoplastic breast surgery: A global perspective on practice, availability and training. World J Surg 2008;32:2570-7. [CrossRef]
• 12. Dixon JM, Venizelos B, Chan P. Latissimus dorsi miniflap: A technique for extending breast conservation. Breast 2002;11:58-65. [CrossRef]
• 13. National mastectomy and breast reconstruction oudit. 2010. Available from: http:// www.ic.nhs.uk/webfiles/services/NCASP/AUDİTS%20 and %20 reports/whs %20 IC%20 MBR%20 2010%20 Audit%20 interactive %202024-06-10%20 final.pdf.accessed.march1,2011.
• 14. Awan BA, Samargandi OA, Aldaqal SM, Alharbi AM, AlGhaithib Z. The attitude and perception of breast reconstruction by general surgeons in Saudi Arabia. Ann Saudi Med 2013;33:559-65. 15. Cardoso MJ, Macmillan RD, Merck B, Munhaz AM, Roibery R. Training in oncoplastic surgery: an international consensus. The 7th Portuquese senology congress, vilamoura, 2009. Breast 2010;19:538-40. [CrossRef] 16. Anderson BO, Braun S, Carlson RW, Gralow JR, Lagios MD, Lehman C, et al. Overview of breast health care guidelines for countries with limited resources. Breast J 2003;9(Suppl) 2:S42-50.
• 17. İzmir Society of Breast Disease. I. Symposium and Course of the Macromasty and Breast Cancer. 2004.
• 18. Residency training in general surgery; core cirruculum. Ankara: Turkish Surgical Association Press; 2006.
• 19. Cardoso MJ, Cardoso JS, Vrieling C, Macmillan D, Rainsbury D, Heil J, et al. Recommendations for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat 2012;135:629-37. [CrossRef]
• 20. EORTC BCC6 Manual for clinical research and treatment in breast cancer. 5th edition. London: Greenwich Medical Media; 2004.
• 21. Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 2009;124:345-53. [CrossRef]
• 22. Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M, Schneider A, et al. Comparison between breast volume measurment using 3D surface imaging and classical techniques. Breast 2007;16:137-45. [CrossRef]
• 23. Fung JT, Chan SW, Chiu AN, Cheung PS, Lam SH. Mamografic determination of breast volume by eliptical cone estimation. World J Surg 2010;34:142-5. [CrossRef