title: Survey of American and Canadian general surgeons' perceptions of margin status and practice patterns for breast conserving surgery.
abstract: Although breast conservation surgery (BCS) is commonly performed, several aspects of the procedure remain controversial. We undertook a cross-sectional survey to compare Canadian (CDN) and American (AM) general surgeons' reported BCS practice patterns to better understand the cross-border differences in early-stage breast cancer surgery care. A modified Dillman Method survey was mailed to 1,447 AM and 1,443 CDN surgeons. Factors evaluated included preoperative assessment, margin definition, surgical techniques, and re-excision practices. The response rate was 26% and 51% for AM and CDN surgeons, respectively. There was variation in use of preoperative core biopsies. American surgeons required wider margins for invasive cancer and ductal carcinoma in situ, and more often recommend re-excision for invasive cancer with 1 and 2 mm margins (p < 0.05). There was also variability in surgical techniques used for intraoperative margin assessment. Wide variation in BCS practice was observed, with some of this variability related to surgeon country.
authors: Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
authors: Elena
authors: E
authors: Parvez
authors: Nicole
authors: N
authors: Hodgson
authors: Sylvie D
authors: SD
authors: Cornacchi
authors: Amanda
authors: A
authors: Ramsaroop
authors: Maggie
authors: M
authors: Gordon
authors: Forough
authors: F
authors: Farrokhyar
authors: Geoffrey
authors: G
authors: Porter
authors: May Lynn
authors: ML
authors: Quan
authors: Francis
authors: F
authors: Wright
authors: Peter J
authors: PJ
authors: Lovrics
mesh_terms: D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000601:surgery*; D002170:Canada; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery; D003430:Cross-Sectional Studies; D003625:Data Collection; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States
keywords: breast conserving surgery; margin status; mastectomy; re-excision; surgical decision-making; survey