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Current Practice of Therapeutic Mammaplasty: A Survey of Oncoplastic Breast Surgeons in England.

Aggarwal S, Marla S, Nyanhongo D, Kotecha S, Basu NN - Int J Surg Oncol (2016)

Bottom Line: Superior-medial pedicle was preferred by the majority of surgeons (62%) followed by inferior pedicle (34%).One in five surgeons would not perform TM in smokers and patients with multifocal disease.There is a wide variation in the practice of TM amongst OBS.

View Article: PubMed Central - PubMed

Affiliation: Queen Elizabeth Hospital NHS Foundation Trust, Birmingham B15 2TH, UK.

ABSTRACT

Introduction: Therapeutic mammaplasty (TM) is a useful technique in the armamentarium of the oncoplastic breast surgeon (OBS). There is limited guidance on patient selection, technique, coding, and management of involved margins. The practices of OBS in England remain unknown.

Methods: Questionnaires were sent to all OBS involved with the Training Interface Group. We assessed the number of TM cases performed per surgeon, criteria for patient selection, pedicle preference, contralateral symmetrisation, use of routine preoperative MRI, management of involved margins, and clinical coding.

Results: We had an overall response rate of 43%. The most common skin resection technique utilised was wise pattern followed by vertical scar. Superior-medial pedicle was preferred by the majority of surgeons (62%) followed by inferior pedicle (34%). Twenty percent of surgeons would always proceed to a mastectomy following an involved margin, whereas the majority would offer reexcision based on several parameters. The main absolute contraindication to TM was tumour to breast ratio >50%. One in five surgeons would not perform TM in smokers and patients with multifocal disease.

Discussion: There is a wide variation in the practice of TM amongst OBS. Further research and guidance would be useful to standardise practice, particularly management of involved margins and coding for optimal reimbursement.

No MeSH data available.


Related in: MedlinePlus

Nipple areolar complex pedicle. Please rank the pedicle most commonly used (1 = most often used, 6 = least often used, average scores out of 6).
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fig2: Nipple areolar complex pedicle. Please rank the pedicle most commonly used (1 = most often used, 6 = least often used, average scores out of 6).

Mentions: 62% of respondents reported that they used the superomedial pedicle most often and 34% used inferior pedicle (Figure 2). Only 20% of respondents always offered a contralateral symmetrising procedure at the time of primary surgery, while 13% said that they would never offer this procedure simultaneously. Most surgeons (57%) reported that they would offer this procedure sometimes, for example, if there was a large difference between breast sizes.


Current Practice of Therapeutic Mammaplasty: A Survey of Oncoplastic Breast Surgeons in England.

Aggarwal S, Marla S, Nyanhongo D, Kotecha S, Basu NN - Int J Surg Oncol (2016)

Nipple areolar complex pedicle. Please rank the pedicle most commonly used (1 = most often used, 6 = least often used, average scores out of 6).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4821971&req=5

fig2: Nipple areolar complex pedicle. Please rank the pedicle most commonly used (1 = most often used, 6 = least often used, average scores out of 6).
Mentions: 62% of respondents reported that they used the superomedial pedicle most often and 34% used inferior pedicle (Figure 2). Only 20% of respondents always offered a contralateral symmetrising procedure at the time of primary surgery, while 13% said that they would never offer this procedure simultaneously. Most surgeons (57%) reported that they would offer this procedure sometimes, for example, if there was a large difference between breast sizes.

Bottom Line: Superior-medial pedicle was preferred by the majority of surgeons (62%) followed by inferior pedicle (34%).One in five surgeons would not perform TM in smokers and patients with multifocal disease.There is a wide variation in the practice of TM amongst OBS.

View Article: PubMed Central - PubMed

Affiliation: Queen Elizabeth Hospital NHS Foundation Trust, Birmingham B15 2TH, UK.

ABSTRACT

Introduction: Therapeutic mammaplasty (TM) is a useful technique in the armamentarium of the oncoplastic breast surgeon (OBS). There is limited guidance on patient selection, technique, coding, and management of involved margins. The practices of OBS in England remain unknown.

Methods: Questionnaires were sent to all OBS involved with the Training Interface Group. We assessed the number of TM cases performed per surgeon, criteria for patient selection, pedicle preference, contralateral symmetrisation, use of routine preoperative MRI, management of involved margins, and clinical coding.

Results: We had an overall response rate of 43%. The most common skin resection technique utilised was wise pattern followed by vertical scar. Superior-medial pedicle was preferred by the majority of surgeons (62%) followed by inferior pedicle (34%). Twenty percent of surgeons would always proceed to a mastectomy following an involved margin, whereas the majority would offer reexcision based on several parameters. The main absolute contraindication to TM was tumour to breast ratio >50%. One in five surgeons would not perform TM in smokers and patients with multifocal disease.

Discussion: There is a wide variation in the practice of TM amongst OBS. Further research and guidance would be useful to standardise practice, particularly management of involved margins and coding for optimal reimbursement.

No MeSH data available.


Related in: MedlinePlus