Breast conserving surgery versus mastectomy: cancer practice by general surgeons in Iran.
BACKGROUND
There appear to be geographical differences in decisions to perform mastectomy or breast conserving surgery for early-stage breast cancer. This study was carried out to evaluate general surgeons' preferences in breast cancer surgery and to assess the factors predicting cancer practice in Iran.


METHODS
A structured questionnaire was mailed to 235 general surgeons chosen from the address list of the Iranian Medical Council. The questionnaire elicited information about the general surgeons' characteristics and about their work experience, posts they have held, number of breast cancer operations performed per year, preferences for mastectomy or breast conserving surgery, and the reasons for these preferences.


RESULTS
In all, 83 surgeons returned the completed questionnaire. The results indicated that only 19% of the surgeons routinely performed breast conserving surgery (BCS) and this was significantly associated with their breast cancer case load (P < 0.01). There were no associations between BCS practice and the other variables studied. The most frequent reasons for not performing BCS were uncertainty about conservative therapy results (46%), uncertainty about the quality of available radiotherapy services (32%), and the probability of patients' non-compliance in radiotherapy (32%).


CONCLUSIONS
The findings indicate that Iranian surgeons do not routinely perform BCS as the first and the best treatment modality. Further research is recommended to evaluate patients' outcomes after BCS treatment in Iran, with regard to available radiotherapy facilities and cultural factors (patients' compliance).
Najafi
Massoome
M
Iranian Center for Breast Cancer, Tehran, Iran. mdmasoume@yahoo.com
Ebrahimi
Mandana
M
Kaviani
Ahmad
A
Hashemi
Esmat
E
Montazeri
Ali
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D002986:Clinical Trials as Topic; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007492:Iran; D008297:Male; D008408:Mastectomy / Q000379:methods* / Q000706:statistics & numerical data*; D015412:Mastectomy, Segmental / Q000379:methods* / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital; D008875:Middle Aged; D015233:Models, Statistical; D010349:Patient Compliance; D011878:Radiotherapy / Q000379:methods / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome