Practice patterns in breast cancer surgery: Canadian perspective.

Area of Science:

• Oncology
• Surgical Practice
• Public Health

Background:

• Breast cancer management is evolving.
• Surgical care is a key component of breast cancer treatment.
• Understanding current practice patterns is essential for quality improvement.

Purpose of the Study:

• To describe current breast cancer surgical practice patterns among Canadian surgeons.
• To identify factors associated with the use of immediate breast reconstruction.
• To assess general surgeons' perceptions regarding their role in breast cancer care.

Main Methods:

• A 31-item questionnaire was sent to 1172 active General Surgeons accredited by the Royal College of Physicians and Surgeons of Canada.
• Anonymous responses were collected and analyzed.
• Multivariate analysis was used to identify factors associated with immediate breast reconstruction.

Main Results:

• 519 surgeons (81% of respondents) treated breast cancer, with most in community settings.
• 76% of surgeons devoted <25% of their practice to breast disease; 42% performed ≤2 breast cancer operations/month.
• Immediate breast reconstruction was used by 57% of surgeons, associated with higher surgeon volume, oncology fellowship, and academic practice.

Conclusions:

• Most Canadian breast cancer surgery is performed by general surgeons with limited specialized interest or high clinical volume.
• Despite this, the majority of surgeons believe general surgeons should perform breast cancer surgery.
• Variability exists in practice patterns, highlighting potential areas for focused training and resource allocation.