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Awareness of residents’ technical ability can affect margin status in breast conserving operations

  • Joel VanderVelde
  • Jarvis W. Walters
  • Chiu-Hsieh Hsu
  • Elizabeth M. N. Ferguson
  • Jennifer Lee
  • Daniel M. Caruso
  • Ian K. KomenakaEmail author
Review
  • 6 Downloads

Abstract

Purpose

The current study was performed to determine if awareness of the potential affect of residents could affect margin status.

Methods

Retrospective review of all patients who underwent lumpectomy from July 2006 to May 2017 was evaluated. The effect of surgical residents’ participation and their technical ability was evaluated to determine the effect on margin status. Logistic regression analysis was performed to determined factors which affect margin status.

Results

Of 444 patients, 14% of patients had positive margins. The positive margin rate was lower during the second time period after the effect of technical ability of the residents was known 12% versus 19% (p = 0.10). Greater participation by the attending surgeon (32% vs. 21%) occurred in the second time period. In multivariate logistic regression analysis, operations done by residents with satisfactory technical skills or attending surgeon were less likely to have positive margins than those done by residents with unsatisfactory technical skills (OR 0.19, 95% CI 0.10–0.38; p = 0.0001). With mean follow-up of 48 months, 1.4% had local recurrences as a first event.

Conclusions

Technically ability of residents appears to affect margin status after lumpectomy. Increased intervention by the attending surgeon can improve this outcome.

Keywords

Lumpectomy Breast conservation Margin Teaching Technical ability 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This retrospective study was approved by the Institutional Review Board.

Research involving human and animal participants

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Not applicable as this was a retrospective study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryMaricopa Medical CenterPhoenixUSA
  2. 2.Arizona Cancer Center, University of ArizonaTucsonUSA
  3. 3.Mel and Enid Zuckerman Arizona College of Public HealthUniversity of ArizonaTucsonUSA
  4. 4.Arizona State UniversityPhoenixUSA

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