The impact of providing an oncoplastic service on the workload of a specialist breast unit

Increasing breast specialization triggered a review of our surgical activity. All 10,000 elective inpatient and day case procedures between 1998 and 2008 were grouped into six categories: oncological, primary, secondary and revisional oncoplastic, and other breast and nonbreast procedures. Overall, surgical activity increased, with a rise in breast and a fall in nonbreast procedures, as a result of a changing caseload in each category (chi-squared for linear trend = 55.24: p < 0.00001). These included increases in oncological procedures, secondary oncoplastic, and revisional oncoplastic procedures. Increased oncoplastic activity was associated with a reduction in other breast procedures (chi-squared for linear trend = 04.94: p < 0.00001). The impact of breast specialization reported in the 1990's has accelerated with the introduction of oncoplastic surgery. This has major short-term and long-term implications when planning a modern breast service.