Author
Roel S. Tolentino ,
Samuel D. Ang ,
Conrado C. Cajucom
Related Institution
Publication Information
Sub Type
Journal Article, Original
Title
Philippine Journal of Surgical Specialties
Date of Publication
October-December 2004
Abstract OBJECTIVES: This study was designed to determine the practice of general surgeons at St. Lukes Medical Center on breast conserving surgery (BCS), and to identify the factors that are correlated with the number of BCS done by these surgeons. METHODS: In June 2003, a 24-item questionnaire dealing with BCS was distributed to all general surgeons practicing at St. Lukes Medical Center. The questionnaires were retrieved within one month. RESULTS: Of the 133 surgeons who were given questionnaires, 128 (96 percent) replied. The mean age of the surgeons was 45 years (range=3 1-77). There were 123 males and 5 females. One hundred ten surgeons (86 percent) would offer BCS. The most common reason for doing BCS by surgeons was for cosmesis. The number one factor considered by surgeons before doing BCS was the tumor size. The average maximum size of tumor the respondents would consider for BCS was 3 cm (range=1.0-5.0). Seventy-three percent preferred the linear accelerator over cobalt for postoperative radiotherapy. When asked where the radiotherapy should be done, 70 percent chose the private hospitals primarily due to quality of service. The number one reason why patients were hesitant to undergo BCS according to the surgeons was the patients fear of recurrence. Lack of surgeons education and training were identified as the most common reason why BCS is not popular in the Philippines. The most popular recommendation given was the education of surgeons to increase awareness of BCS. The number of BCS done was positively correlated with the age of the doctor (p=0.008), years in practice (p=0.006), and if the surgeon offers BCS (p=0.004).
References
1. National Statistical Coordination Board. Regional Unit XII, Philippines: Fact Sheet No. 1, 1998. (March Seri)
2. Fisher, B. , Redmond, C. , Poisson, R. , et al., . Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancerN Engl J Med 320, 822-828, 1989. Retrieved from:
3. Veronesi, U. , Luini, A. , Del Vecchio, M. , et al., . Radiotherapy after breast-preserving surgery in women with localized cancer of the breastN Engl J Med 328, 1587-1591, 1993. Retrieved from:
4. Arriagada, R. , Le, M. G., Rochard, F. , Contesso, G. . Consevative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer GroupJ Clin Oncol 14, 1558-1564, 1996. Retrieved from:
5. Morrow, M. . Breast conserving therapy: who and why?J Surg Oncol 84, 55-56, 2003
6. Hayward, J. . The guyWorld J Surg 1, 134-144, 1977
7. Sarrrazin, D. , Le, M. , Arriagada, R. , et al., . Ten-year results of a randomized trial comparing a conservative treament to mastectomy in early breast cancer Radiother Oncol 14, 177-183, 1989. Retrieved from:
8. Veronesi, U. , Saccozzi, R. , Del Vecchio, M. , et al., . Comparing radical mastectomy with quadrantectomy, axillary lymph node dissection and radiotherapy in patients with small cancers of the breastN Engl J Med 305, 6-12, 1981. Retrieved from:
9. Fisher, B. , Redmond, C. , Poisson, R. , et al., . Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancerN Engl J Med 320, 822-830, 1989. Retrieved from:
10. Lichter, A. , Lippman, M. , Danforth, D. , et al., . Mastectomy versus breast-conserving therapy in stage I and Ii carcinoma of the breast: a randomized trial at the National Cancer Institute J Clin Oncol 10, 976-982, 1992. Retrieved from:
11. Van Dongen, J. , Bartelink, H. , Fentimen, I. , et al., . Randomized clinical trial to assess the value of breast conserving therapy on stage I and II breast cancer: EORTC 10801 trialMonog J Natl Cancer Inst 11, 15-20, 1992. Retrieved from:
12. Blichert-Toft, M. , Rose, C. , Andersen, J. , et al., . Danish randomized trial comparing breast conservation therapy with mastectomy: six years of life table analysisMonog J Natl Cancer Inst 11, 19-25, 1992. Retrieved from:
13. Fisher, B. , Anderson, S. , Bryant, J. , et al., . Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancerN Engl J Med 347, 1227-1232, 2002. Retrieved from:
14. Veronesi, U. , Cascinelli, N. , Mariani, L. , et al., . Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancerN Engl J Med 337, 956-962, 1997. Retrieved from:
15. Komoike, Y. , Motomura, K. , Inaji, H. , Kasugai, T. , Koyama, H. . Repeat lumpectomy for patients with ipsilateral breast tumor recurrence after breast-conserving surgery. Preliminary resultsScand J Surg 91, 251-254, 2002. Retrieved from:
16. McArdle, J. M., Hughson, A. V., McArdle, C. S.. Reduced psychological morbidity after breast conservationBr J Surg 77, 1221-1223, 1990. Retrieved from:
17. Curan, D. , van Dongen, J. P., Aaronson, N. K., et al., . Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC Trial 10801Eur J Cancer 34, 307-314, 1998. Retrieved from:
18. Hahn, C. A., Marks, L. B., Chen, D. Y., Lind, P. A., Lind, H. M., Prosnitz, L. R.. Breast conservation rates-barriers betwen tertiary care and community practiceInt J Radiat Oncol Biol Phys 55, 1196-1199, 2003. Retrieved from:
19. Skinner, K. A., Dunnington, G. . Surgery for breast cancer. In: Hindle WH, (ed.): Breast Care: A Clinical Guidebook for Women New York: Springer, 1999. 206-224.