Current Practices and Barriers to the Integration of Oncoplastic Breast Surgery: A Canadian Perspective

Abstract

Lack of training, access to plastic surgeons, and absence of appropriate reimbursement for these cases are significant barriers to the adoption of oncoplastic techniques.

Oncoplastic breast surgery: Achieving oncological and aesthetic outcomes

“…In the recent decades, the surgical management of breast cancer has steadily evolved from radical surgery to breast conservation. As a result, oncoplastic surgical techniques have emerged and are expanding dramatically . Oncoplastic surgery combines oncologic resection with immediate breast reconstruction using techniques derived from plastic surgery.…”

Duas técnicas de cirurgia oncoplástica simultaneamente no tratamento de tumor de mama na linha paraesternal direita

“…Contudo, é necessário mais treinamentos de cirurgiões de mama e mastologistas, em diferentes partes do país, para que mais mulheres sejam beneficiadas por técnicas de reconstrução mamária. Mesmo em países mais desenvolvidos, como o Canadá, a falta de experiência em técnicas de Oncoplastia é a principal barreira para que as mulheres não consigam a reconstrução das mamas 6 . O conhecimento de diferentes técnicas de cirurgia Oncoplástica se faz necessário para que o cirurgião de mama consiga reverter situações especiais, quando a localização tumoral dificulta a remoção do mesmo, sem deixar um resultado final insatisfatório na superfície da glândula mamária.…”

Training Canadian surgeons in oncoplastic breast surgery: Where do we stand?

“…However, compared with the rest of the international community, Canada has been fairly slow in its clinical uptake of OPS, with a recent study highlighting the lack of available formal training opportunities as a major barrier. 5 Oncoplastic surgery has not traditionally been part of a general surgeon's residency training, nor has it been a formal part of Canadian breast or general surgical oncology fellowship training. These fellowships have traditionally emphasized the development of surgical expertise in the multidisciplinary management of breast disease, with no formal OPS training built into the curriculum.…”

“…Practising Canadian surgeons currently performing OPS have generally obtained their skills through courses taken internationally, 5 as historically this has been an unmet need in Canada. In partnership with the University of Toronto, University of Ottawa and Western University, the Canadian Breast Surgery Innovations (CBSI) group began offering full-day OPS workshops in late 2016.…”