Practice patterns and perceptions of margin status for breast conserving surgery for breast carcinoma: National Survey of Canadian General Surgeons.
BACKGROUND
We surveyed Canadian General Surgeons to examine decision-making in early stage breast cancer.


METHODS
A modified Dillman Method was used for this mail survey of 1443 surgeons. Practice patterns and factors that influence management choices for: preoperative assessment, definition of margin status, surgical techniques and recommendations for re-excision were assessed.


RESULTS
The response rate was 51% with 41% treating breast cancer. Most (80%) were community surgeons, with equal distribution of low/medium/high volume and years of practice categories. Approximately 25% of surgeons "sometimes or frequently" performed diagnostic excisional biopsies while 90% report "frequently" or "always" performing preoperative core biopsies. There was marked variation in defining negative and close margins, in the use of intra-operative margin assessment techniques and recommendations for re-excision.


CONCLUSIONS
Responses revealed significant variation in attitudes and practices. These findings likely reflect an absence of consensus in the literature and potential gaps between best evidence and practice.
Department of Surgery, McMaster University, Canada. lovricsp@mcmaster.ca
Peter J
PJ
Lovrics
Maggie
M
Gordon
Sylvie D
SD
Cornacchi
Forough
F
Farrokhyar
Amanda
A
Ramsaroop
Nicole
N
Hodgson
May Lynn
ML
Quan
Francis
F
Wright
Geoffrey
G
Porter
D001291:Attitude of Health Personnel; D001706:Biopsy / Q000379:methods / Q000706:statistics & numerical data; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002170:Canada; D003661:Decision Support Techniques; D005260:Female; D013502:General Surgery; D019538:Health Care Surveys; D006801:Humans; D008408:Mastectomy; D015412:Mastectomy, Segmental / Q000379:methods / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011300:Preoperative Care / Q000379:methods / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012086:Reoperation