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Breast Modular Resection Surgery Teaching Model Improves the Effect of Teaching Under Regional Anesthesia for Breast
Ru Yao1, Aocheng Wu1, Jie Lian1
1Department of Breast Surgery, Peking Union Medical College Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China.
Background:
Breast-conserving surgery (BCS) combined with sentinel lymph node biopsy (SLNB) is a standard treatment for early-stage breast cancer. However, surgical variability and patient discomfort under regional anesthesia present challenges for training programs and consistent clinical outcomes. To address this, we implemented a breast modular resection (BMR) surgical teaching course designed to deconstruct BCS + SLNB into standardized modules and evaluated its impact on training effectiveness and patient outcomes in the day surgery setting under regional anesthesia.
Methods:
A total of 273 patients underwent BCS with SLNB between 2019 and 2022, performed by six attending breast surgeons. Patients were divided into a classical procedure resection group (n = 124) and a BMR group (n = 149). All surgeries were performed under regional anesthesia. Clinical and subjective outcome indicators, such as re-excision rate, pain scores, cosmetic satisfaction, and hospital stay, were analyzed.
Results:
The BMR group showed significantly more favorable perioperative outcomes, including lower re-excision rates (3.85% vs. 11.88%, p = 0.038), reduced intraoperative pain (p < 0.05), decreased seroma incidence (9.62% vs. 20.79%, p = 0.032), and enhanced breast symmetry satisfaction (p = 0.008). A substantially higher proportion of BMR patients were discharged on postoperative Day 1 (79.81% vs. 31.68%, p < 0.001), confirming the feasibility of safe, same-day BCS + SLNB. There were no differences in long-term complications or recurrence.
Conclusions:
The BMR-based teaching model improved surgical performance, standardized the technique, and enhanced the patient experience for BCS + SLNB under regional anesthesia. This structured modular approach provides a replaceable framework for surgical education and may facilitate broader adoption of day-case breast cancer surgery without compromising oncologic safety or patient comfort.
