Maine Medical Center, Portland, ME, USA.
Lakeland Regional Health, Lakeland, FL, USA.
Ann Surg Oncol. 2022 Oct;29(10):6144-6150. doi: 10.1245/s10434-022-12136-5. Epub 2022 Jul 19.
The adoption of innovation is essential to the evolution of patient care. Breast surgical oncology advances through incorporating new techniques, devices, and procedures. Historical changes in practice standards from radical to modified radical mastectomy or axillary node dissection to sentinel node biopsy reduced morbidity without sacrifice in oncologic outcome. Contemporary oncoplastic techniques afford broader consideration for breast conservation and the potential for improved cosmetic outcomes. At present, many breast surgeons face the decision of which wireless device to use for localization of nonpalpable lesions. Consideration for future changes, such as robotic mastectomy, are on the horizon. No guideline exists to assist breast surgeons in the adoption of innovation into practice. The Ethics Committee of the American Society of Breast Surgeons acknowledges that breast surgeons confront many questions associated with onboarding innovation. This paper aims to provide a framework for asking relevant questions along with the ethical principles to consider when integrating an innovation into practice.
创新的采用对于患者护理的发展至关重要。乳腺外科肿瘤学的进步是通过引入新技术、设备和程序实现的。从根治性乳房切除术到改良根治性乳房切除术或腋窝淋巴结清扫术到前哨淋巴结活检术，手术标准的历史变化降低了发病率，同时保持了肿瘤学结果。当代的肿瘤整形技术为乳房保留提供了更广泛的考虑，并有可能改善美容效果。目前，许多乳腺外科医生面临着选择哪种无线设备来定位不可触及病变的决策。对于机器人乳房切除术等未来的变化也在考虑之中。目前还没有指南来帮助乳腺外科医生将创新应用于实践。美国乳腺外科学会伦理委员会承认，乳腺外科医生面临着许多与创新相关的问题。本文旨在为提出相关问题提供一个框架，并讨论在将创新整合到实践中时需要考虑的伦理原则。
