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Background <p>Historically, breast reconstruction was performed by plastic surgeons. The Brazilian Society of Mastology (SBM) implemented initiatives to improve breast surgeons’ training in oncoplastic techniques; however, the current proportion of surgeons performing these techniques remained unknown. This study aimed to determine the proportion of Brazilian breast surgeons performing oncoplastic surgery, their previous training, the complexity of procedures performed, and factors influencing adoption of techniques.</p> Methods <p>In this survey, a structured questionnaire was sent to all SBM-affiliated breast surgeons between July and December 2023. Outcome proportions were estimated using binomial distribution. Adjusted proportion ratios (aPR) were calculated using robust Poisson regression.</p> Results <p>A 60.2% valid response rate was achieved (<i>n</i> = 1059/1759). Almost half of the respondents performed oncoplastic surgery, with most being young (&lt; 40&#xa0;years) (aPR: 1.66; 1.31–1.10; <i>p</i> &lt; 0.001), male (aPR: 1.39; 1.22–1.59; <i>p</i> &lt; 0.001), southern residents (aPR: 1.39; 1.18–1.63; <i>p</i> &lt; 0.001), with a specialist degree in breast disease (aPR: 1.19; 1.00–1.42; <i>p</i> &lt; 0.004), primarily trained in general surgery (aPR: 1.32; 1.16–1.51; <i>p</i> &lt; 0.001) and secondarily in breast surgery (aPR: 1.41; 1.08–1.85; <i>p</i> = 0.01), and performing &gt; 100&#xa0;surgeries/year (aPR: 1.72; 1.49–1.99; <i>p</i> &lt; 0.001). The techniques most commonly mastered were simple displacement (88.7%), therapeutic mammoplasty or contralateral symmetrization (96.4%), reconstruction with implants or tissue expanders (93.6%), extreme oncoplasty (81%), skin- and nipple-sparing (99%) or skin-reducing mastectomy (84.2%), and thoracoabdominal flaps (71.7%).</p> Conclusions <p>A high proportion of Brazilian mastologists perform oncoplastic surgery. These findings provide key insights to further enhance training and improve outcomes.</p>

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National Survey on Attitudes of Brazilian Breast Surgeons Regarding Oncoplastic Surgery: Success of a Training Model

  • 期刊论文

  • 发表日期：

    2025年5月6日

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  • Francisco Pimentel Cavalcante,
  • Vilmar Marques de Oliveira,
  • Patrícia Klarmann Ziegelmann,
  • Fabrício Palermo Brenelli,
  • Régis Resende Paulinelli,
  • Augusto Tufi Hassan,
  • Guilherme Garcia Novita,
  • Eduardo Camargo Millen,
  • Felipe Pereira Zerwes,
  • André Mattar,
  • Marcelo Antonini,
  • Antônio Luiz Frasson,
  • Cícero de Andrade Urban,
  • Eduardo Carvalho Pessoa,
  • Carlos Alberto Ruiz,
  • Jorge Villanova Biazus,
  • Ruffo Freitas-Junior,
  • Rene Aloisio da Costa Vieira

摘要

Background

Historically, breast reconstruction was performed by plastic surgeons. The Brazilian Society of Mastology (SBM) implemented initiatives to improve breast surgeons’ training in oncoplastic techniques; however, the current proportion of surgeons performing these techniques remained unknown. This study aimed to determine the proportion of Brazilian breast surgeons performing oncoplastic surgery, their previous training, the complexity of procedures performed, and factors influencing adoption of techniques.

Methods

In this survey, a structured questionnaire was sent to all SBM-affiliated breast surgeons between July and December 2023. Outcome proportions were estimated using binomial distribution. Adjusted proportion ratios (aPR) were calculated using robust Poisson regression.

Results

A 60.2% valid response rate was achieved (n = 1059/1759). Almost half of the respondents performed oncoplastic surgery, with most being young (< 40 years) (aPR: 1.66; 1.31–1.10; p < 0.001), male (aPR: 1.39; 1.22–1.59; p < 0.001), southern residents (aPR: 1.39; 1.18–1.63; p < 0.001), with a specialist degree in breast disease (aPR: 1.19; 1.00–1.42; p < 0.004), primarily trained in general surgery (aPR: 1.32; 1.16–1.51; p < 0.001) and secondarily in breast surgery (aPR: 1.41; 1.08–1.85; p = 0.01), and performing > 100 surgeries/year (aPR: 1.72; 1.49–1.99; p < 0.001). The techniques most commonly mastered were simple displacement (88.7%), therapeutic mammoplasty or contralateral symmetrization (96.4%), reconstruction with implants or tissue expanders (93.6%), extreme oncoplasty (81%), skin- and nipple-sparing (99%) or skin-reducing mastectomy (84.2%), and thoracoabdominal flaps (71.7%).

Conclusions

A high proportion of Brazilian mastologists perform oncoplastic surgery. These findings provide key insights to further enhance training and improve outcomes.