Effect of surgeon's caseload on the quality of surgery and breast cancer recurrence

Päivi Peltoniemi; Heini Huhtala; Kaija Holli; Liisa Pylkkänen

doi:10.1016/j.breast.2012.04.007

Effect of surgeon's caseload on the quality of surgery and breast cancer recurrence

Breast. 2012 Aug;21(4):539-43. doi: 10.1016/j.breast.2012.04.007. Epub 2012 May 16.

Authors

Päivi Peltoniemi¹, Heini Huhtala, Kaija Holli, Liisa Pylkkänen

Affiliation

¹ Department of Palliative Medicine, Tampere University Hospital and Medical School, University of Tampere, 33014 Tampere, Finland. [email protected]

PMID: 22595246
DOI: 10.1016/j.breast.2012.04.007

Abstract

The aim of this study was to evaluate the effects of the caseloads of individual surgeons on breast cancer primary care and outcome. The extent of primary breast cancer and axillary surgery and the appearance of local recurrences were evaluated for 1377 women operated in Pirkanmaa region between 1.1.1997 and 31.12.2001 and followed- up at least until 31.12.2008 or death. Caseloads of each surgeon were divided into three categories: over 550, 100-200 and under 60. Breast conserving surgery was performed more often by surgeons with the highest (OR 1.32) and the middle (OR 1.54) caseload volumes compared to those with the lowest volumes (p = 0.018). Surgeons with the lowest caseloads also dissected fewer lymph nodes (mean 9.4 versus 11.2 in the highest and 10.9 in the middle caseload volumes; p ≤ 0.001). There were no differences in recurrences between the groups during the mean follow-up time of 8.9 years.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Axilla
Breast Neoplasms / mortality
Breast Neoplasms / pathology
Breast Neoplasms / surgery*
Carcinoma, Ductal, Breast / mortality
Carcinoma, Ductal, Breast / pathology
Carcinoma, Ductal, Breast / surgery
Carcinoma, Intraductal, Noninfiltrating / mortality
Carcinoma, Intraductal, Noninfiltrating / pathology
Carcinoma, Intraductal, Noninfiltrating / surgery
Carcinoma, Lobular / mortality
Carcinoma, Lobular / pathology
Carcinoma, Lobular / surgery
Female
Finland
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Logistic Models
Lymph Node Excision / standards
Lymph Node Excision / statistics & numerical data*
Mastectomy / methods
Mastectomy / standards
Mastectomy / statistics & numerical data*
Middle Aged
Neoplasm Recurrence, Local / epidemiology
Neoplasm Recurrence, Local / etiology
Neoplasm Recurrence, Local / prevention & control*
Quality of Health Care
Registries
Treatment Outcome
Workload / statistics & numerical data*