Assessing the effect of a hands-on oncoplastic surgery training course: A survey of Canadian surgeons

Fernando A Angarita; Megan E Leroux; Vanessa N Palter; Jeannie Richardson; Angel Arnaout; Renee M Hanrahan; Marianna Kapala; Muriel Brackstone; Fahima Osman

doi:10.1016/j.suronc.2020.10.003

Assessing the effect of a hands-on oncoplastic surgery training course: A survey of Canadian surgeons

Surg Oncol. 2020 Dec:35:428-433. doi: 10.1016/j.suronc.2020.10.003. Epub 2020 Oct 6.

Authors

Fernando A Angarita¹, Megan E Leroux², Vanessa N Palter³, Jeannie Richardson¹, Angel Arnaout⁴, Renee M Hanrahan⁵, Marianna Kapala¹, Muriel Brackstone⁶, Fahima Osman⁷

Affiliations

¹ Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
² Department of Surgery, North York General Hospital, Toronto, ON, Canada.
³ International Centre for Surgical Safety, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
⁴ Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada.
⁵ Division of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
⁶ Division of General Surgery, Department of Surgery, Western University, London, ON, Canada.
⁷ Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Department of Surgery, North York General Hospital, Toronto, ON, Canada. Electronic address: fahima.osman@nygh.on.ca.

PMID: 33039848
DOI: 10.1016/j.suronc.2020.10.003

Abstract

Background: The adoption of oncoplastic surgery in North America is poor despite evidence supporting the benefits. Surgeons take courses to acquire oncoplastic techniques, however, the effect of these courses is unknown. This study aimed to assess the impact of a hands-on oncoplastic course on surgeons' comfort with oncoplastic techniques and rate of adoption of these techniques in their practice.

Material and methods: An online 10-question survey was developed and distributed to surgeons who had participated in a hands-on oncoplastic course offered in Ontario, Canada. Categorical data were reported using frequencies and percentages.

Results: A total of 105 surveys were sent out of which 69 attending surgeons responded (response rate: 65.7%). All respondents stated cosmesis was of the utmost importance in breast conserving surgery. The most common oncoplastic techniques they currently use included glandular re-approximation (98.4%), undermining of skin (93.6%), undermining of the nipple areolar complex (63.4%), and de-epithelialization and repositioning of the nipple areola complex (49.2%). Only 26% of respondnets stated they used more advanced techniques such as mammoplasty. Sixty percent of surgeons reported they used oncoplastic techniques in at least half of their cases. Ninety-two percent of respondents stated that the hands-on course increased the amount of oncoplastic techniques in their practice. At least 70% of respondents stated they would do another hands-on course. The main factor that facilitated the uptake of oncoplastic techniques was a better understanding of surgical techniques and planning.

Conclusion: A hands-on oncoplastic course helps surgeons adopt oncoplastic surgery techniques into their clinical practice. This teaching model allows surgeons to become comfortable with a variety of techniques. This study supports the relevance of a hands-on oncoplastic course to enhance the availability of safe oncoplastic surgery for breast cancer patients.

Keywords: Breast conserving surgery; Education; Oncoplastic surgery; Survey.

MeSH terms

Breast Neoplasms / pathology
Breast Neoplasms / surgery*
Education, Medical, Continuing / methods*
Female
Humans
Male
Mammaplasty / methods*
Mastectomy / methods*
Ontario
Practice Patterns, Physicians' / standards*
Prognosis
Surgeons / education*
Surgical Oncology / education*
Surveys and Questionnaires