PMID: 9524704Apr 3, 1998Paper

Surgeon variability in treating nonpalpable breast cancer: surgical oncology as a value-added specialty

Annals of Surgical Oncology
S L BlairR K Orr

Abstract

Several studies have demonstrated a relatively low rate of breast conservation surgery (BCS) in the United States. Few have analyzed the impact of individual surgeon variability on the outcome of the procedure, and none have contrasted surgical oncologists versus general surgeons in the treatment of nonpalpable breast cancer. A blinded review was done of 409 excisions for nonpalpable breast cancer performed by 11 board-certified general surgeons (GS, n = 221) and one surgical oncologist (SO, n = 185) in a teaching institution. We compared surgical margins, need for reexcision, and breast conservation rates. Although there were no significant differences in patient and tumor characteristics, there were surprising differences between the GS and SO, especially related to surgical margins and final treatment. The SO has a significantly higher rate of frozen section compared to GS (81% vs. 64%, P < 0.01) and a lower rate of positive margin at the time of original biopsy (25% vs. 41%, P < 0.01). These differences translated into lower necessity for reexcision of tumor (18% vs. 48%, P < 0.01) and higher rate of BCS (88% vs. 70%, P < 0.01). This study demonstrates marked differences among trained general surgeons. The additional experi...Continue Reading

References

Jan 11, 1992·CA: a Cancer Journal for Clinicians·R T OsteenD P Winchester
Nov 1, 1990·Archives of Surgery·H R AlexanderD W Kinne
Sep 1, 1993·Archives of Surgery·L TafraA E Giuliano

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Citations

Nov 5, 2003·Annals of Surgical Oncology·Lorraine TafraRonald T Grenko
Apr 22, 2008·The Journal of Urology·Ofer YossepowitchPaul Russo
Jun 4, 2005·ANZ Journal of Surgery·Katrina SpilsburyC D J Holman
Jun 24, 2005·American Journal of Surgery·Karen HiotisKristin Skinner
Apr 6, 2005·Seminars in Radiation Oncology·Neenad M Shah, David E Wazer
Aug 4, 2005·ANZ Journal of Surgery·Katrina SpilsburyC D J Holman
Feb 8, 2005·The Breast : Official Journal of the European Society of Mastology·D M IngramK Jamrozik
Mar 24, 2005·Journal of Surgical Oncology·Pat W Whitworth, John C Rewcastle
Jan 11, 2005·Cancer·Karen HiotisKristin A Skinner
Mar 29, 2019·European Journal of Cancer Care·Albert Ho-HuynhAlan de Costa
May 12, 2001·The Breast Journal·D. Scott LindEdward M. Copeland

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