Original Scientific Reports

World Journal of Surgery

, Volume 28, Issue 1, pp 80-86

Practice Patterns in Breast Cancer Surgery: Canadian Perspective

  • Geoffrey A. PorterAffiliated withDepartment of Surgery, Dalhousie University, Cancer Care Nova Scotia  Email author 
  • , Heather McMulkin-TaitAffiliated withDepartment of Surgery, Dalhousie University, Cancer Care Nova Scotia

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Breast cancer is a common disease, and the surgical management is continually evolving. The objective of this study was to describe the current breast cancer practice patterns among Canadian surgeons. All active General Surgeons (n = 1172), as accredited by the Royal College of Physicians and Surgeons of Canada, were sent a 31-item questionnaire. Anonymous responses were collected and analyzed regarding surgeon demographics, practice, and perceptions regarding surgical care of breast cancer patients. Overall 640 active surgeons responded; of these, 519 (81%) treated breast cancer and formed the study cohort. Practice settings included community (55%), community with university affiliation (28%), and academic (17%). The majority of surgeons (76%) stated that < 25% of their practice was devoted to breast disease, and 42% performed ≤ 2 breast cancer operations/month. Immediate breast reconstruction (IBR) was used by 57% of surgeons. On multivariate analysis, higher surgeon volume of breast cancer cases (p = 0.0008), fellowship training in Surgical Oncology (p = 0.009), community population (p = 0.001), and academic practice setting (p < 0.0001) were independently associated with the use of IBR. Of the 640 surgeons who responded, 79% stated that breast cancer surgery should be performed by “most general surgeons.” In Canada, most breast cancer surgery was performed by general surgeons who did not appear to have an interest, as defined by training or clinical volume, in breast cancer. Although variability regarding specific surgical issues was found among subgroups of surgeons, the majority of respondents felt that most general surgeons should treat breast cancer.