Survey of the application of the korean clinical practice recommendations on breast cancer treatment: the utility of the korean breast cancer society guidelines

How do surgeons approach breast cancer surgery in Turkey? A national survey

BACKGROUND

The aim of this study was to investigate the experience, practice and approaches of general surgeons in relation to the treatment of breast cancer in Turkey.

METHODS

A survey was conducted between November 2012 and February 2013 with 453 general surgeons who claimed to perform breast surgery. Initial and most preferred approaches for breast cancer surgery and demographic features of participants were questioned. Initial approaches of surgeons for a suspected breast mass were assessed with a clinical scenario.

RESULTS

A total of 12.6 % of practicing general surgeons in Turkey responded to the survey. A multidisciplinary assessment was employed by 57.2 % of participants. The most frequently used diagnostic tool was needle biopsies (64.9 %) and the most frequently performed surgery for early stage cancers was breast-conserving surgery (72.2 %). The initial approach for locally advanced breast cancer was neoadjuvant chemotherapy (59.8 %) and mastectomy for metastatic cancer (22.7 %). Sentinel lymph node biopsies were utilized by 59.2 % of participants by different methods in appropriate cases. Oncoplastic breast surgery was performed by 9.0 % of participants, frequently or constantly. The surgeons' initial approaches for the clinical scenario were imaging (56.7 %) and biopsy (40.6 %).

CONCLUSIONS

Although there are efforts to improve up-to-date approaches towards breast cancer surgery by surgeons, currently there are significant inadequacies for evidence-based medicine practices.

The approach of general surgeons to oncoplastic and reconstructive breast surgery in Turkey: a survey of practice patterns

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.

Surgeons' Approaches and Professional Perspectives on Breast Masses: A National Survey in Turkey

OBJECTIVE

General surgeons' approaches to breast masses in their daily practices and their perspectives for issues on breast diseases and breast surgery are investigated through a survey.

MATERIALS AND METHODS

Answers of 524 general surgeons for the survey "Approach to breast diseases and breast surgery" between November 2012 and February 2013 were assessed. Demographic features, approaches to the breast masses, and answers for the clinical scenerios of surgeons were questioned. Surgeons were asked about management of breast cancer and the future role of surgeons for oncoplastic breast surgery and breast diseases.

RESULTS

Participants were representing 14.6% of all general surgeons in Turkey. The survey revealed that breast diseases are the most common cause for admission in general surgery outpatient clinics. Needle biopsies were employed by 241 (60%) respondents. Three hundred and seventy-one (71%) participants indicated that breast cancer management could be accurately conducted by the general surgeons. Two hundred and seventy-three (52%) respondents think that oncoplastic breast surgery should be performed by a general surgeon and 241 (41%) respondents predict that the role of general surgeons for breast diseases and breast surgery will decrease in the future.

CONCLUSION

Basic approaches towards breast masses need to be improved in our country despite the highest frequency of breast diseases in outpatient admissions. The views and opinions of surgeons on breast diseases and the course of breast surgery in different regions and different communities need to be defined and clarified.