[The surgical treatment of nonpalpable breast carcinoma in a university teaching hospital and a general teaching hospital by residents-in-training and surgeons; comparable results].
OBJECTIVE
To compare the results of the surgical treatment of nonpalpable breast cancer between two teaching hospitals in The Netherlands; the University Medical Centre Utrecht (UMCU) and the Rijnstate Hospital, Arnhem (RHA).


METHODS
Retrospective.


METHODS
A total of 240 patients from the UMCU (n = 126) and the RHA (n = 114) diagnosed with a malignancy at stereotactic histological needle biopsy from 1 February 1997-31 May 2002 were included. The average age of the patients at the RHA was 61.3 and at the UMCU 58.0 years. The total number of procedures was recorded, as well as the type of operation and whether the first surgeon was a resident-in-training or registered as a surgeon.


RESULTS
Of the 240 patients, biopsy results showed that 163 had invasive carcinoma (IC) and 77 had a ductal carcinoma in situ (DCIS). In 74% of cases one operation was sufficient (79% in the RHA versus 69% in the UMCU; p = 0.08). In the RHA fewer operations per patient were carried out before radical resection was attained (1.25 versus 1.4; p = 0.02). IC was more often treated by breast conserving surgery in the RHA than in the UMCU (74% versus 55%; p = 0.01). The intention to treat DCIS by breast conserving surgery was more often seen in the UMCU than in the RHA (90% versus 69%; p = 0.02). Of all operations analysed in the RHA 48% were performed by a resident-in-training as first surgeon versus 87% in the UMCU (p < 0.001). In those patients whose first operation was carried out by a resident-in-training, the percentages of 'radical resections' were equal: 78% in the RHA and 77% in the UMCU.


CONCLUSIONS
Outcomes of surgical treatment were comparable in both types of teaching hospital. Good results were achieved in nonpalpable breast cancer surgery that was carried out by residents-in-training.
Alysis Zorggroep, locatie Rijnstate, afd. Heelkunde, Arnhem.
M L E A
ML
Landheer
L E
LE
Hoorntje
J H G
JH
Klinkenbijl
I H M
IH
Borel Rinkes
D001707:Biopsy, Needle / Q000379:methods; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery; D005260:Female; D013502:General Surgery / Q000592:standards*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies; D016896:Treatment Outcome