Is the reexcision rate higher if breast conservation surgery is performed by surgical trainees?
BACKGROUND
It is essential that surgical trainees obtain adequate operative experience without compromising patient outcome. The aim of this study was to compare the reexcision and local recurrence rates between consultants (attending surgeons) and surgical trainees (residents) after breast conservation surgery.


METHODS
Prospective data were obtained from the local breast cancer registry for all patients who had breast-conservation surgery between 1994 and 2000. Reexcision was carried out if the margins were deemed inadequate after taking the clinical and pathologic features into consideration.


RESULTS
The primary operation (n = 505) was wide local excision = 377; wire-guided excisions = 107; and quadrantectomy = 21 patients. Sixty-five percent (n = 330) were operated on by consultants and 35% (n = 175) by residents. Second procedures (n = 137) were performed for involved margins in 95 and close margins in 31 patients. The patients in both groups were equally matched. The reexcision rate was similar for both groups of surgeons (P = 0.58). On multivariate analysis, the factors determining reexcision were nodal status, type of first procedure, and tumor type. The local recurrence rate was comparable in both groups (P = 0.33).


CONCLUSIONS
In patients with breast cancer treated by conservation surgery during a 7-year period, the reexcision and local recurrence rates were similar for both groups of surgeons.
Moorthy
Krishna
K
Breast Care Unit, Department of Surgery, Bedford Hospital, Bedford, MK42 9DJ, United Kingdom. k.moorthy@ic.ac.uk
Asopa
Vipin
V
Wiggins
Elizabeth
E
Callam
Michael
M
D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology