Breast Modular Resection Surgery Teaching Model Improves the Effect of Teaching Under Regional Anesthesia for Breast Conserving Surgery and Sentinel Lymph Node Biopsy in Day Surgery
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Published on: May 17, 2024
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.
