Däster Kavitha, Garcia Ricardo Pardo, Masannat Yazan, Kothari Ashutosh
Brust-Zentrum Zürich, Zürich, Switzerland.
Royal Bolton Hospital NHS Trust, Member of GEICAM, Bolton, UK.
Gland Surg. 2024 Feb 29;13(2):248-256. doi: 10.21037/gs-23-380. Epub 2024 Feb 27.
Oncoplastic breast surgery (OPS) has become an integral part of breast cancer surgery for both breast conservation and mastectomies. In recent years, the emphasis on early detection and the advances in systemic and locoregional therapy has improved prognosis leading to an increased focus on survivorship and quality of life issues including patients' short and long-term aesthetic appearance as a key part of the surgical management. There is a significant variation across Europe in the type of specialist performing breast cancer surgery and the provision of OPS as such. In the traditional model, breast cancer care was provided by gynecologists in some countries, general surgeons, surgical oncologists, and breast surgeons in others. However recently, surgeons throughout Europe have extended their skill-base to include level 1 and 2 OPS and implant- and pedicle-flap based breast reconstruction. For breast surgeons to become proficient in these techniques, a standardized level of training and expertise is needed. The European Society of Mastology (EUSOMA) set standards for a specialist health professional in the field of breast cancer, the European Union of Medical Specialists (UEMS) examinations and the global curriculum that was developed by the American Society of Surgical Oncology (SSO) and the European Society of Surgical Oncology (ESSO) aims to improve standards of OPS practice across Europe. The new generation of breast surgeons, therefore, should be equipped with the necessary skill set to provide high quality OPS while keeping abreast of novel technologies and techniques aiming to provide patients with excellent long-term quality of life.
肿瘤整形乳房手术(OPS)已成为乳腺癌保乳手术和乳房切除术不可或缺的一部分。近年来,对早期检测的重视以及全身和局部区域治疗的进展改善了预后,这使得人们更加关注生存质量问题,包括患者的短期和长期美观外观,这是手术管理的关键部分。在欧洲,进行乳腺癌手术的专科医生类型以及OPS的提供情况存在显著差异。在传统模式下,一些国家由妇科医生提供乳腺癌护理,其他国家则由普通外科医生、外科肿瘤学家和乳腺外科医生提供。然而,最近欧洲各地的外科医生都扩展了他们的技能基础,包括一级和二级OPS以及基于植入物和带蒂皮瓣的乳房重建。为了让乳腺外科医生精通这些技术,需要标准化的培训水平和专业知识。欧洲乳腺病学会(EUSOMA)为乳腺癌领域的专科医疗专业人员制定了标准,欧洲医学专家联盟(UEMS)的考试以及由美国外科肿瘤学会(SSO)和欧洲外科肿瘤学会(ESSO)制定的全球课程旨在提高欧洲各地OPS的实践标准。因此,新一代乳腺外科医生应具备必要的技能组合,以提供高质量的OPS,同时跟上旨在为患者提供卓越长期生活质量的新技术和新方法。