Training Oncoplastic Breast Surgeons: The Canadian Fellowship Experience

Maxwell, Jessica E.; Arnaout, Angel; Hanrahan, Renee; Brackstone, Muriel

doi:10.3747/co.24.3554

Cited by 17 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Variation in the management of DCIS has been demonstrated previously at both national and international levels including various ongoing studies regarding the optimal management of this disease [ 7 , 8 , 13 , 14 ]. A study looking at variation in practice in the UK, for example, demonstrated national differences in the rates of, and indications for, mastectomy, axillary management, and follow-up procedures for DCIS patients [ 15 , 16 , 17 ]. These international uncertainties regarding the optimal management of DCIS offer a possible explanation for the lack of consistency regarding its management across Canada.…”

Section: Discussionmentioning

confidence: 99%

National Variations in the Work-Up, Investigation, and Surgical Management of Ductal Carcinoma In Situ of the Breast across Canadian Surgeons

Seguin

Peiris

2021

Current Oncology

View full text Add to dashboard Cite

Variation in the management of Ductal Carcinoma In Situ (DCIS) of the breast occur at both national and international levels. The aim of this study is to determine the degree of, and reasons behind, this variation in the workup and treatment of DCIS among Canadian surgeons. We developed a 35-question survey involving the pre-, peri, and post-operative management of DCIS using SurveyMonkey®. The survey was sent out via email and responses were analyzed using SurveyMonkey® and Microsoft Excel. 51/119 (43%) of the Canadian General Surgeons contacted participated in this study. Some variation was observed in the utilization of pre-operative imaging with 29/48 (60%) surgeons routinely using ultrasound. Perceived contraindications to breast conserving therapy also varied with multicentricity (54%) and the presence of diffuse microcalcifications (13%). Nearly all respondent’s (98%) patients had access to immediate breast reconstruction following a mastectomy but 14/48 (29%) of respondents’ patients were required to travel a mean distance of 300 km to undergo the procedure. Substantial variation was also seen during follow-up with half (52%) of surgeons following up patients for >1 month in their surgical clinic. There is considerable variation in the management of DCIS among Canadian Surgeons. The present study indicates the need for pan-Canadian, evidence-based guidelines to ensure a standardized management strategy for patients with DCIS.

show abstract

Section: Discussionmentioning

confidence: 99%

National Variations in the Work-Up, Investigation, and Surgical Management of Ductal Carcinoma In Situ of the Breast across Canadian Surgeons

Seguin

Peiris

2021

Current Oncology

View full text Add to dashboard Cite

show abstract

“…The Society of Surgical Oncology offers 48 approved breast surgical oncology fellowship training programmes across the USA and Canada, but only 11 of these include some level of OBS training . In Canada, apart from the Society of Surgical Oncology fellowships, there are very few formal breast surgical oncology fellowships available . For example, the 1‐year programme offered through the University of Toronto accepts only one to two fellows per year and the curriculum contains no formal OBS training: the ability to independently perform OBS procedures is not one of the course's aims .…”

Section: Discussionmentioning

confidence: 99%

“…8 In Canada, apart from the Society of Surgical Oncology fellowships, there are very few formal breast surgical oncology fellowships available. 9 For example, the 1-year programme offered through the University of Toronto accepts only one to two fellows per year and the curriculum contains no formal OBS training: the ability to independently perform OBS procedures is not one of the Another major public hospital centre has developed its own integrated model, following a long-term collaboration between breast and plastic surgery … we have parallel lists and we have a clinic on the day when the all-day list is on so that breast surgeons come out of clinic and do the mastectomy and go back to clinic and plastic surgeons can actually start in clinic and then go to theatre, so the surgical team swaps. But it's just been persistence taking many years to work towards a model that we had defined many years prior and nothing happens quickly.…”

Section: Discussionmentioning

confidence: 99%

On the frontiers of change: breast surgeons' views on demarcation between surgical sub‐specialties in Australia

Flitcroft

Brennan

Spillane

2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background The emergence of breast oncoplastic surgery provides women with more surgical options for improved aesthetics following breast‐conserving surgery and for breast reconstruction (BR) following mastectomy. For some established breast and plastic surgeons, this development may be perceived as increasing competition for patients and raises the potential for demarcation issues between and within surgical sub‐specialties. The objectives of the study were to document surgeons' views on demarcation between general/breast, oncoplastic/breast and plastic reconstructive breast surgeons in Australia, to examine the potential impact demarcation issues may have on informed patient choice and to recommend ways of reducing them. Methods In‐depth qualitative interviews were conducted with a convenience sample of 31 (22 oncoplastic and nine plastic reconstructive) surgeons who performed BR. Results Descriptive analysis of the interviews revealed a range in the perceptions of the extent of demarcation. Six common themes were identified: oncoplastic techniques are unnecessary and potentially unsafe; reconstructive surgery should be left to ‘the experts’; non‐referral of patients for discussion of surgical options they do not offer; professional jealousy; workload capacity; and the old versus the new guard. Potential solutions suggested by the participants focused on improving relations between oncoplastic and plastic reconstructive surgeons and changes to breast surgical training. Conclusion While most surgeons were optimistic about the current divide diminishing with time, a more pro‐active stance is required if patient‐centred care is to be improved. Roundtable discussions with a broad range of stakeholders are planned to begin this process.

show abstract

“…To realize the true potential of OBS in breast cancer management in Indian patients, there is an exigent need to create a well-trained work force of breast surgeons, radiologists, medical oncologists, radiation oncologists, geneticists, psychology counselors, and nurses who are aligned to the its ever-evolving principles and practices. Successful OBS training programs have been created in many countries [42,43]. To this effect, senior breast oncoplastic surgeons from India and the UK have created a structured training program from aspiring breast oncoplasty surgeons [www.breastoncoplasty.org].…”

Section: Need For Obs Training In Indiamentioning

confidence: 99%

Oncoplastic Breast Surgery in India: Thinking Globally, Acting Locally

Koppiker¹,

Chintamani

Dixit³

2019

Indian J Surg

View full text Add to dashboard Cite

Training Oncoplastic Breast Surgeons: The Canadian Fellowship Experience

Abstract: Background Oncoplastic breast surgery combines traditional oncologic breast conservation with plastic surgery

Cited by 17 publications

References 19 publications

National Variations in the Work-Up, Investigation, and Surgical Management of Ductal Carcinoma In Situ of the Breast across Canadian Surgeons

National Variations in the Work-Up, Investigation, and Surgical Management of Ductal Carcinoma In Situ of the Breast across Canadian Surgeons

On the frontiers of change: breast surgeons' views on demarcation between surgical sub‐specialties in Australia

Oncoplastic Breast Surgery in India: Thinking Globally, Acting Locally

Contact Info

Product

Resources

About