Results from the American Society of Breast Surgeons Oncoplastic Surgery Committee 2017 Survey: Current Practice and Future Directions

Chatterjee, Abhishek; Gass, Jennifer; Burke, M Barbara; Kopkash, Katherine; El‐Tamer, Mahmoud; Holmes, Dennis R.; Clark, Patricia; Reiland, Juliann

doi:10.1245/s10434-018-6586-3

Cited by 39 publications

(21 citation statements)

References 22 publications

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“…Although OS had a lower patient population compared to PM in the NSQIP database, it showed an 11% increase per year. This increase in OS correlates with recent breast surgeon survey results that have shown high interests in learning OS techniques amongst breast surgeons [16]. Historically, OS has evolved since its introduction in the 1980s and follows breast conservation principles that remove fairly large regions of the breast as part of the oncologic resection followed by volume displacement (mastopexy/reduction) or volume replacement (locoregional flap)techniques [4, 17, 18].…”

Section: Discussionmentioning

confidence: 78%

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis

Jonczyk

Jean

Graham

et al. 2018

Breast Cancer Res Treat

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143

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Purpose Breast cancer surgical techniques are evolving. Few studies have analyzed national trends for the multitude of surgical options that include partial mastectomy (PM), mastectomy without reconstruction (M), mastectomy with reconstruction (M+R), and PM with oncoplastic reconstruction (OS). We hypothesize that the use of M is declining and likely correlates with the rise of surgery with reconstructive options (M+R, OS). Methods A retrospective cohort analysis was conducted using the ACS-NSQIP database from 2005 to 2016 and ICD codes for IBC and DCIS. Patients were then grouped together based on current procedural terminology (CPT) codes for PM, M, M+R, and OS. In each group, categories were sorted again based on additional reconstructive procedures. Data analysis was conducted via Pearson’s chi-squared test for demographics, linear regression, and a non-parametric Mann-Kendall test to assess a temporal trend. Results The patient cohort consisted of 256,398 patients from the NSQIP data base; 197,387 meet inclusion criteria diagnosed with IBC or DCIS. Annual breast surgery trends changed as follows: PM 46.3–46.1% (p = 0.21), M 35.8–26.4% (p = 0.001), M+R 15.9–23.0% (p = 0.03), and OS 1.8–4.42% (p = 0.001). Analyzing the patient cohort who underwent breast conservation, categorical analysis showed a decreased use of PM alone (96–91%) with an increased use of OS (4–9%). For the patient cohort undergoing mastectomy, M alone decreased (69–53%); M+R with muscular flap decreased (9–2%); and M+R with implant placement increased (20–40%)—all three trends p < 0.0001. Conclusion The modern era of breast surgery is identified by the increasing use of reconstruction for patients undergoing breast conservation (in the form of OS) and mastectomy (in the form of M+R). Our study provides data showing significant trends that will impact the future of both breast cancer surgery and breast training programs.

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Section: Discussionmentioning

confidence: 78%

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis

Jonczyk

Jean

Graham

et al. 2018

Breast Cancer Res Treat

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143

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“…[1][2][3][4] This approach has gained wide acceptance in Europe for larger tumours or tumours in a cosmetically challenging location where volume loss may affect overall cosmesis; however, is has been adopted more slowly by the majority of breast surgeons in Canada, even though studies have demonstrated the oncologic safety of this technique and it has been endorsed by major surgical societies such as the American Society of Breast Surgeons. 3,9,10 To date, there have been very few studies reporting on OPS outcomes in Canada. This study aims to assess the incidence of immediate and delayed surgical complications, such as infection, bleeding, need for reoperation and interference with adjuvant treatment, and oncologic outcomes such as local and distal recurrence over a 5-year period in a Canadian community setting.…”

mentioning

confidence: 99%

An alternative to standard lumpectomy: a 5-year case series review of oncoplastic breast surgery outcomes in a Canadian setting

Knowles

Maxwell

Lumsden

et al. 2020

CJS

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Background: Oncoplastic surgery (OPS) is becoming the new standard of care for breast-conserving surgery (BCS). It has become increasingly popular in Europe; however, it has not yet been widely accepted in North America. This study aims to describe the experience with OPS at a Canadian tertiary care centre. Methods: This study is a retrospective case series consisting of consecutive OPS cases at a single Canadian centre, the Royal Victoria Regional Health Centre in Barrie, Ontario, between 2009 and 2015. Results: A total of 275 women who consecutively underwent OPS were included. The average size of the tumour was 17 mm (standard deviation [SD] 13 mm; range 0-110 mm). The average specimen weight was 155 g (SD 146 g; range 15-1132 g). Invasive ductal carcinoma was the most common diagnosis (237 patients, 86.2%), followed by ductal carcinoma in situ (18 patients, 6.6%) and then invasive lobular carcinoma (15 patients, 5.5%). A positive margin was recorded in 37 (13.5%) patients. Immediate postoperative complications included seroma and edema (32.7%), wound infection (13.1%), hematoma (8.7%) and delayed wound healing (6.5%). A delay to adjuvant therapy due to postoperative complications occurred in 7 of 217 (3.2%) patients. The median follow-up was 18 months. There were local and distant recurrences in 9 (3.3%) and 2 (0.7%) patients, respectively. Overall survival was 99.3%. Conclusion: The findings of this study are comparable to results in the literature on OPS and demonstrate that OPS is an attractive alternative to standard lumpectomy for Canadian general surgeons who treat breast cancer. Contexte : La chirurgie oncoplastique (COP) est en passe de devenir la nouvelle norme pour la chirurgie conservatrice du sein (CCS). Elle est de plus en plus populaire en Europe, mais elle n'a pas encore été largement adoptée en Amérique du Nord. Cette étude vise à décrire l'expérience d'un établissement de soins tertiaires au Canada en matière de COP. Méthodes : Cette étude repose sur une série rétrospective de cas de COP dans un établissement canadien, le Centre régional de santé Royal Victoria de Barrie, en Ontario, entre 2009 et 2015. Résultats : En tout, 275 cas consécutifs de COP ont été inclus. La taille moyenne des tumeurs était de 17 mm (écart-type [É.-T.] 13 mm; éventail 0-110 mm). Le poids moyen des spécimens était de 155 g (É.-T. 146 g; éventail 15-1132 g). Le diagnostic le plus fréquent était le carcinome canalaire invasif (237 patientes, 86,2 %), suivi du carcinome canalaire in situ (18 patientes, 6,6 %), puis du carcinome lobulaire invasif (15 patientes, 5,5 %). Une marge positive a été enregistrée chez 37 patientes (13,5 %). Parmi les complications postopératoires immédiates, mentionnons sérome et oedème (32,7 %), infection de plaie (13,1 %), hématome (8,7 %) et retard de cicatrisation de la plaie (6,5 %). Un retard du traitement adjuvant dû à des complications postopératoires est survenu chez 7 patientes sur 217 (3,2 %). Le suivi médian a été de 18 mois. On a noté des récurrences locales et à distance chez 9 (3...

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“…In 2018, the committee published the results of a survey, indicating that there was great interest among members in learning oncoplastic surgery but only 19% of members reported performing a reduction excision and only 10% had performed a contralateral procedure for symmetry. 2 In 2019, the ASBrS and the Oncoplastic Surgery Committee published, in this issue of the Annals, a consensus statement defining and classifying oncoplastic surgery. 3 That same year, at the Annual Meeting of the ASBrS, an entire session devoted to oncoplastic surgery was, for the first time, included in the main program, demonstrating the society's commitment to oncoplastic surgery and its desire to bring it into the mainstream of surgical practice.…”

Section: Evolutionmentioning

confidence: 99%

Oncoplastic Breast Surgery: From Oblivion to Mainstream

Silverstein

2019

Ann Surg Oncol

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Results from the American Society of Breast Surgeons Oncoplastic Surgery Committee 2017 Survey: Current Practice and Future Directions

Cited by 39 publications

References 22 publications

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis

An alternative to standard lumpectomy: a 5-year case series review of oncoplastic breast surgery outcomes in a Canadian setting

Oncoplastic Breast Surgery: From Oblivion to Mainstream

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