Nightingale Centre, Breast Surgery Department, University Hospital of South Manchester, Manchester M23 9LT, United Kingdom.
J Plast Reconstr Aesthet Surg. 2011 Jul;64(7):878-83. doi: 10.1016/j.bjps.2010.12.001. Epub 2010 Dec 31.
Bilateral Breast Reduction (BBR) is a common procedure performed by Breast and Plastic surgeons in the UK. No consensus exists regarding preoperative screening for malignancy or for selective criteria for such screening. Preoperative BBR screening practices among UK Breast and Plastic surgeons are unknown.
Ascertain the preoperative and postoperative BBR screening practices of UK Breast and Plastic surgeons.
A questionnaire was posted to all 434 Breast and 335 Plastic surgeons in the UK. All results were analysed with relevant statistical methods.
64% of Breast surgeons and 72% of Plastic surgeons responded. 40% of Breast surgeons and 91% of Plastic surgeons perform BBR. Routine radiological screening: 92% Breast 41% Plastic (p < 0.05). Routine breast examination prior to BBR: 98% Breast 91% Plastic. Routine histology for BBR specimens: 96% Breast 90% Plastic. Selective screening of patients aged 30-40 years old: Breast 38% Plastic 10%. Selective screening of patients aged 40-50: Breast 78%, Plastic 53%. Selective screening of patients with strong family history of breast cancer: Breast 72%, Plastic 91%. Selective screening of patients with previous breast cancer: Breast 77%, Plastic 93%.
There are significant differences in practice between UK Breast surgeons and Plastic surgeons in preoperative oncological screening for BBR. The large discrepancy in preoperative radiological screening, reflects a ubiquitous pro-screening ideology among Breast surgeons not prevalent among Plastic surgeons. These results will provoke debate towards the direction of consensus to ultimately reflect best practice.
双侧乳房缩小术（BBR）是英国乳腺和整形外科医生常见的手术。对于术前筛查恶性肿瘤或此类筛查的选择性标准，尚无共识。英国乳腺和整形外科医生在术前 BBR 筛查方面的实践尚不清楚。
确定英国乳腺和整形外科医生术前和术后的 BBR 筛查实践。
向英国所有 434 名乳腺外科医生和 335 名整形外科医生发放问卷。所有结果均采用相关统计方法进行分析。
64%的乳腺外科医生和 72%的整形外科医生做出了回应。40%的乳腺外科医生和 91%的整形外科医生进行 BBR。常规放射学筛查：92%的乳腺外科医生，41%的整形外科医生（p<0.05）。术前 BBR 常规乳房检查：98%的乳腺外科医生，91%的整形外科医生。BBR 标本常规组织学检查：96%的乳腺外科医生，90%的整形外科医生。30-40 岁患者的选择性筛查：乳腺外科医生 38%，整形外科医生 10%。40-50 岁患者的选择性筛查：乳腺外科医生 78%，整形外科医生 53%。有强烈乳腺癌家族史的患者的选择性筛查：乳腺外科医生 72%，整形外科医生 91%。有既往乳腺癌史的患者的选择性筛查：乳腺外科医生 77%，整形外科医生 93%。
英国乳腺外科医生和整形外科医生在 BBR 的术前肿瘤筛查方面存在显著的实践差异。术前放射学筛查的巨大差异反映了乳腺外科医生普遍存在的积极筛查理念，而这种理念在整形外科医生中并不普遍。这些结果将引发关于达成共识方向的争论，最终反映最佳实践。
