Practice patterns and perceptions of margin status for breast conserving surgery for breast carcinoma: National Survey of Canadian General Surgeons

Breast. 2012 Dec;21(6):730-4. doi: 10.1016/j.breast.2012.07.017. Epub 2012 Aug 16.

Abstract

Background: We surveyed Canadian General Surgeons to examine decision-making in early stage breast cancer.

Methods: A modified Dillman Method was used for this mail survey of 1443 surgeons. Practice patterns and factors that influence management choices for: preoperative assessment, definition of margin status, surgical techniques and recommendations for re-excision were assessed.

Results: The response rate was 51% with 41% treating breast cancer. Most (80%) were community surgeons, with equal distribution of low/medium/high volume and years of practice categories. Approximately 25% of surgeons "sometimes or frequently" performed diagnostic excisional biopsies while 90% report "frequently" or "always" performing preoperative core biopsies. There was marked variation in defining negative and close margins, in the use of intra-operative margin assessment techniques and recommendations for re-excision.

Conclusions: Responses revealed significant variation in attitudes and practices. These findings likely reflect an absence of consensus in the literature and potential gaps between best evidence and practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel*
  • Biopsy / methods
  • Biopsy / statistics & numerical data
  • Breast / pathology
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Canada
  • Decision Support Techniques
  • Female
  • General Surgery*
  • Health Care Surveys
  • Humans
  • Mastectomy
  • Mastectomy, Segmental / methods
  • Mastectomy, Segmental / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Preoperative Care / methods
  • Preoperative Care / statistics & numerical data
  • Referral and Consultation / statistics & numerical data
  • Reoperation