Abstract
Background
The aim of this study was to investigate the experience, practice and approaches of general surgeons in relation to the treatment of breast cancer in Turkey.
Methods
A survey was conducted between November 2012 and February 2013 with 453 general surgeons who claimed to perform breast surgery. Initial and most preferred approaches for breast cancer surgery and demographic features of participants were questioned. Initial approaches of surgeons for a suspected breast mass were assessed with a clinical scenario.
Results
A total of 12.6 % of practicing general surgeons in Turkey responded to the survey. A multidisciplinary assessment was employed by 57.2 % of participants. The most frequently used diagnostic tool was needle biopsies (64.9 %) and the most frequently performed surgery for early stage cancers was breast-conserving surgery (72.2 %). The initial approach for locally advanced breast cancer was neoadjuvant chemotherapy (59.8 %) and mastectomy for metastatic cancer (22.7 %). Sentinel lymph node biopsies were utilized by 59.2 % of participants by different methods in appropriate cases. Oncoplastic breast surgery was performed by 9.0 % of participants, frequently or constantly. The surgeons’ initial approaches for the clinical scenario were imaging (56.7 %) and biopsy (40.6 %).
Conclusions
Although there are efforts to improve up-to-date approaches towards breast cancer surgery by surgeons, currently there are significant inadequacies for evidence-based medicine practices.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Benson JR, Jatoi I. The global breast cancer burden. Future Oncol. 2012;8(6):697–702.
Tuncer M. Significance of cancer in Turkey the burden of disease and cancer control policies. In: Tuncer M, editor. Cancer control in Turkey, vol. 74. Ankara: Onur, Health Ministry; 2008. p. 5–9.
Jatoi I. Options in breast cancer local therapy: who gets what? World J Surg. 2012;36(7):1498–502.
Anderson BO, Braun S, Carlson RW, Gralow JR, Lagios MD, Lehman C, et al. Overview of breast healthcare guidelines for countries with limited resources. Breast J. 2003;9Suppl 2:S42–50.
Terzi C, Okman U, Eryılmaz M. Türkiye’de Genel Cerrahi Insan Gücü. Ankara: Türk Cerrahi Derneği Yayinlari; 2009. p. 18–32.
Haydaroğlu A. 1.Ulusal Meme Kanseri Konsensusu, Izmir, Kongre Basımevi Matbaası 2007. pp 63–8.
Houssami N, Sainsbury R. Breast cancer: multidisciplinary care and clinical outcomes. Eur J Cancer. 2006;42:2480–91.
Chae BJ, Bae JS, Song BJ, Jung SS. Multidisciplinary team approach in breast cancer: a nationwide survey in Korea. J Korean Surg Soc. 2012;82(6):340–6.
Cantürk NZ, Gulluoglu MB. Türkiye’deki Universite hastanelerinde meme kanseri tanı ve cerrahi tedavisindeki uygulama farklılıkları. Meme Sağlığı Dergisi. 2011;4:207–15.
Veronesi U, Luini A, Galimberti V, Zurrida S. Conservation approaches for the management of stage I/II carcinoma of the breast: Milan Cancer Institute trials. World J Surg. 1994;18(1):70–5.
Hortobagyi GN, Singletary SN, Strong EA. Locally advanced breast cancer. In: Harris JR, Lippman ME, Marrow M, Kent Osborne C, editors. Disorders of the breast, vol. 4. Philadelphia: Lippincott Williams and Wilkins; 2010. p. 745–61.
Mathew J, Asgeirsson KS, Cheung KL, Chan S, Dahda A, Robertson JF. Neoadjuvant chemotherapy for locally advanced breast cancer: a review of the literature and future directions. Eur J Surg Oncol. 2009;35(2):113–22.
Neuman HB, Morrogh M, Gonen M, Van Zee KJ, Morrow M, King TA. Stage IV breast cancer in the era of targeted therapy: does surgery of the primary tumor matter? Cancer. 2010;116(5):1226–33.
Cardoso F, Castiglione M, ESMO Guidelines Working Group. Locally recurrent or metastatic breast cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2009;20(Suppl 4):15–8.
Glynn RW, Williams L, Dixon JM. A further survey of surgical management of the axilla in UK breast cancer patients. Ann R Coll Surg Engl. 2010;92(6):506–11.
Malycha PL, Gough IR, Margaritoni M, Deo SV, Sandalin K, Buccimazza I, et al. Oncoplastic breast surgery: a global perspective on practice, availability and training. World J Surg. 2008;32(12):2570–7.
Andree C, Farhadi J, Goossens D, Masia J, Sarfati I, Germann G, et al. A position statement on optimizing the role of oncoplastic breast surgery. E Plasty. 2012;12:e40.
Gwack G, Lee HK, Kim HJ, Lee SY, Park YL, Lee JW. Survey of the application of the Korea clinical practice recommendations on breast cancer treatment: utility of the Korean Breast Cancer Society Guidelines. J Breast Cancer. 2012;15(2):239–43.
Holloway CM, Gagliardi AR. Percutaneous needle biopsy for breast diagnosis: how do surgeons decide? Ann Surg Oncol. 2009;16(6):1629–36.
Acknowledgments
We would like to express our gratefulness to the Turkish Surgical Association for its and its members’ invaluable support for this survey.
Conflict of interest
The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. The authors received no financial support for the research, authorship and/or publication of this article.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Emiroğlu, M., Inal, A., Sert, İ. et al. How do surgeons approach breast cancer surgery in Turkey? A national survey. Breast Cancer 22, 421–426 (2015). https://doi.org/10.1007/s12282-013-0500-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12282-013-0500-4