Bitoiu Brendon, Grigor Emma, Zeitouni Camille, Arnaout Angel, Zhang Jing
Department of Surgery, Division of Plastics and Reconstructive Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
MD Program, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Plast Surg (Oakv). 2025 Feb;33(1):35-41. doi: 10.1177/22925503231195020. Epub 2023 Aug 21.
There is a lack of previous studies investigating oncoplastic practice trends for breast reconstruction in Canada, particularly from the plastic surgeon perspective. Given the rising popularity of oncoplastic techniques, this study aimed to identify current practice trends for breast and plastic surgeons in Canada. A cross-sectional survey study of breast and plastic surgeons performing oncoplastic surgery across Canada was conducted. Ninety-five surgeons were invited to complete the survey, with 58 respondents (response rate 61%), of which 29 (50.0%) were breast surgeons and 29 (50.0%) were plastic surgeons. Compared to plastic surgeons, breast surgeons performed significantly more level 1 surgeries (27.6 vs 3.45%, < .001). Plastic surgeons performed more level 2 (37.9% vs 13.8%, = .0475) and level 3 (31.4% vs 10.3%, = .00814) surgeries. Breast surgeons identified significant perceived barriers including unfamiliarity with techniques ( = .00513), adjuvant therapy delays ( = .00612), lack of plastic surgery support ( < .001), lack of radiation oncology support ( = .0485), increased OR time ( < .001), lack of OHIP billing codes ( < .001), and post-operative complication management ( = .0372). Breast surgeon comfort with oncoplastic techniques was not correlated with practice duration (R-square = .037, -value = .853). Breast surgeon comfort with contralateral surgery was not correlated with practice setting (R-square = .071, -value = .632). Breast surgeons perceive a lack of training, a lack of support from plastic surgery, concerns regarding appropriate financial remuneration, and worries of increased OR time as barriers in oncoplastic surgery. Collaboration between general breast surgery and plastic surgery is needed for improving training options for oncoplastic surgery in Canada and for providing excellent breast cancer care overall.
此前缺乏针对加拿大乳房重建肿瘤整形手术趋势的研究，尤其是从整形外科医生的角度。鉴于肿瘤整形技术越来越受欢迎，本研究旨在确定加拿大乳房外科医生和整形外科医生当前的手术趋势。对加拿大各地进行肿瘤整形手术的乳房外科医生和整形外科医生进行了一项横断面调查研究。邀请了95名外科医生完成调查，有58名受访者（回复率61%），其中29名（50.0%）是乳房外科医生，29名（50.0%）是整形外科医生。与整形外科医生相比，乳房外科医生进行的1级手术明显更多（27.6%对3.45%，P<0.001）。整形外科医生进行的2级手术（37.9%对13.8%，P=0.0475）和3级手术（31.4%对10.3%，P=0.00814）更多。乳房外科医生确定了一些明显的感知障碍，包括对技术不熟悉（P=0.00513）、辅助治疗延迟（P=0.00612）、缺乏整形外科支持（P<0.001）、缺乏放射肿瘤学支持（P=0.0485）、手术时间增加（P<0.001）、缺乏安大略省医疗保险计划计费代码（P<0.001）以及术后并发症管理（P=0.0372）。乳房外科医生对肿瘤整形技术的熟悉程度与执业年限无关（决定系数R²=0.037，P值=0.853）。乳房外科医生对侧乳房手术的熟悉程度与执业环境无关（决定系数R²=0.071，P值=0.632）。乳房外科医生认为缺乏培训、缺乏整形外科的支持、对适当经济报酬的担忧以及对手术时间增加的担忧是肿瘤整形手术的障碍。加拿大需要普通乳房外科和整形外科之间的合作，以改善肿瘤整形手术的培训选择，并总体上提供优质的乳腺癌护理。
