Teng Teng L, Hall Ryan, Graham Roger A, Reiland Juliann, Chatterjee Abhishek
Division of Surgical Oncology, Department of Surgery, Tufts Medical Center, Boston, MA.
Department of Surgical Oncology, Avera Medical Group Comprehensive Breast Care, Sioux Falls, SD.
Ann Plast Surg. 2019 Apr;82(4S Suppl 3):S256-S258. doi: 10.1097/SAP.0000000000001846.
Breast cancer surgery involves removal of cancer performed by a breast surgeon and reconstruction performed by a plastic surgeon. Historically, many women have not undergone breast reconstruction surgery (BRS), with current literature suggesting that geographic barriers may play a role. Our objective was to determine if there is a geographic shortage of plastic surgeons in the United States and to assess for trends in access to BRS for rural, suburban, and urban populations.
A database investigation of the 2018 membership for the American Society of Breast Surgeons and the American Society of Plastic Surgeons was performed. We searched for a breast surgeon's geographic presence by zip code and looked for the presence of a plastic surgeon within 10 and 20 miles. Zip codes were then categorized as urban, suburban, or rural. Within each population category, the average numbers of breast surgeons and plastic surgeons were quantified.
Twenty-five percent of breast surgeon zip codes had no plastic surgeons located within 10 miles; 10% of breast surgeon zip codes had no plastic surgeon within 20 miles. There were on average 7.03 breast surgeons in each urbanized area. Suburban and rural areas had an average of 1.14 and 1.00 breast surgeons, respectively. There were on average 10.97 plastic surgeons per urbanized area. Suburban and rural areas had, on average, 0.23 and 0.06 plastic surgeons, respectively.
A national comparison of the geographical distribution between breast surgeons and plastic surgeons indicates a shortage of plastic surgeons, especially in rural and suburban areas.
乳腺癌手术包括由乳腺外科医生进行的癌症切除手术以及由整形外科医生进行的重建手术。从历史上看，许多女性并未接受乳房重建手术（BRS），当前文献表明地理障碍可能起到了一定作用。我们的目标是确定美国是否存在整形外科医生的地理短缺情况，并评估农村、郊区和城市人口获得BRS的趋势。
对美国乳腺外科医生协会和美国整形外科医生协会2018年会员进行了数据库调查。我们按邮政编码搜索乳腺外科医生的地理分布，并查找10英里和20英里范围内整形外科医生的情况。邮政编码随后被分类为城市、郊区或农村。在每个人口类别中，对乳腺外科医生和整形外科医生的平均数量进行了量化。
25%的乳腺外科医生邮政编码区域在10英里范围内没有整形外科医生；10%的乳腺外科医生邮政编码区域在20英里范围内没有整形外科医生。每个城市化地区平均有7.03名乳腺外科医生。郊区和农村地区的乳腺外科医生平均分别有1.14名和1.00名。每个城市化地区平均有10.97名整形外科医生。郊区和农村地区的整形外科医生平均分别有0.23名和0.06名。
对乳腺外科医生和整形外科医生地理分布的全国性比较表明存在整形外科医生短缺的情况，尤其是在农村和郊区。
