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Variability in breast cancer surgery training across Europe: An ESSO-EUSOMA international survey
Affiliation: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. Guy''s Hospital, London, Honorary Senior Lecturer King''s College, London, UK;4. Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Nova Medical School, Lisbon, Portugal;5. Breast Surgery Unit, Comprehensive Cancer Center Helsinki University Hospital, Helsinki, Finland;6. ZEBRA Breast Cancer Counselling Centre, Duesseldorf, Germany;7. Department of Head and Neck Cancer Surgery and Surgical Oncology, Medical University of Lodz, Lodz, Poland;8. European Society of Breast Cancer Specialists, Florence, Italy;9. European Society of Surgical Oncology, Brussels, Belgium;10. Breast Unit, Nuovo Ospedale di Prato, Prato, Italy;11. Department of Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg, Sweden;1. Croydon University Hospital, London, UK;2. Royal Marsden Hospital, London, UK;3. Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden;4. Imperial College, London, UK;1. Department of Obstetrics and Gynecology, University Hospital of Bern and University of Berne, Berne, Switzerland;2. Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy;3. Department of Gynaecological Oncology, KK Women''s & Children''s Hospital, Singapore;4. Department of Gynecology and Obstetrics, “Sapienza” University of Rome, Rome, Italy;5. Institute of Pathology, University of Bern, Murtenstrasse 31, Room L310, 3008, Bern, Switzerland;1. Department of Surgery, Tufts Medical Center, Boston, MA;2. Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH;3. Department of Surgery, the University of Pennsylvania, Philadelphia, PA;1. Department of Surgery, Victoria Infirmary Glasgow, UK;2. Department of Surgery, Glasgow Royal Infirmary, UK;3. Department of Surgery, Western Infirmary Glasgow, UK;1. Department of Gynecology and Obstetrics, Agaplesion Markus Hospital, Germany;2. Breast Cancer Center, Hospital Essen Mitte, Germany;3. Department of Obstetrics and Gynaecology, University Hospital of Schleswig-Holstein, Campus Luebeck, Germany;4. Mammazentrum Hamburg, Germany;5. Department of Gynecology and Obstetrics, St. Gertrauden Hospital, Berlin, Germany
Abstract:BackgroundAt 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 methodsGeneral surgeons, surgical oncologists, gynecologist, and plastic surgeons in Europe were invited to participate in this bespoke survey including 19 questions.ResultsThe 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.ConclusionThere 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.
Keywords:Breast surgery  Training  Breast unit  Certification
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