Variability in breast cancer surgery training across Europe: An ESSO-EUSOMA international survey
Rubio IT (1), Wyld L (2), Esgueva A (3), Kovacs T (4), Cardoso MJ (5), Leidenius M (6), Bianca S (7), Kolacinska A (8), Marotti L (9), Lecoq C (10), Biganzoli L (11), Audisio R (12).
(1) Breast Surgical Oncology, Clínica Universidad de Navarra, Madrid, Universidad de Navarra, Spain.
(2) Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
(3) Breast Surgical Oncology, Clínica Universidad de Navarra, Madrid, Universidad de Navarra, Spain.
(4) Guy's Hospital, London, Honorary Senior Lecturer King's College, London, UK.
(5) Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Nova Medical School, Lisbon, Portugal.
(6) Breast Surgery Unit, Comprehensive Cancer Center Helsinki University Hospital, Helsinki, Finland.
(7) ZEBRA Breast Cancer Counselling Centre, Duesseldorf, Germany.
(8) Department of Head and Neck Cancer Surgery and Surgical Oncology, Medical University of Lodz, Lodz, Poland.
(9) European Society of Breast Cancer Specialists, Florence, Italy.
(10) European Society of Surgical Oncology, Brussels, Belgium.
(11) Breast Unit, Nuovo Ospedale di Prato, Prato, Italy.
(12) Department of Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg, Sweden.
At present there is a lack of standardization of training in breast cancer surgery across Europe. The aim of this survey was to assess current practice in Europe regarding training in breast cancer (BC) surgery.
MATERIAL AND METHODS:
General surgeons, surgical oncologists, gynecologist, and plastic surgeons in Europe were invited to participate in this bespoke survey including 19 questions.
The survey was sent to 3.000 surgical oncologists across Europe. A total of 671 physicians (387 general surgeons, 152 gynecologists, 126 surgical oncologist, 31 plastic surgeons) answered the survey (23% response rate). Four hundred and sixty-eight physicians devoted between 50% -100% of their job to treating breast cancer. 45% worked in a community/University hospital within a dedicated Breast Unit.
Specific additional breast surgery training was not universal: 20% had undertaken an accredited breast fellowship, 30% in a Breast Unit as a trainee, 21% had done additional courses, masters or diploma and 8% had not done any additional training. The majority (61%) of respondents worked in Units treating >150 BC cases per year, while 26% of the responders treat >120 new primary cases per year, and 23% less than 50 new cases a year.
Multivariate analysis showed that breast surgeons working in a Breast Unit and treating more than 50 cases/year significantly performed oncoplastic procedures.
There is a great variability in breast cancer surgery training in Europe. It is imperative to develop quality standards for breast cancer surgery training to ensure that patients get standardized and certified surgical management regardless of the country in which they are treated.
CITA DEL ARTÍCULO Eur J Surg Oncol. 2019 Apr;45(4):567-572. doi: 10.1016/j.ejso.2019.01.003. Epub 2019 Jan 5