Original Article

You have full text access to this OnlineOpen article

Skin-sparing mastectomy

Specialty bias and worldwide lack of consensus

  1. Richard J. Bleicher M.D.,
  2. Nora M. Hansen M.D.,
  3. Armando E. Giuliano M.D.†,*

Article first published online: 7 OCT 2003

DOI: 10.1002/cncr.11801

Issue

Cancer

Cancer

Volume 98, Issue 11, pages 2316–2321, 1 December 2003

Additional Information

How to Cite

Bleicher, R. J., Hansen, N. M. and Giuliano, A. E. (2003), Skin-sparing mastectomy. Cancer, 98: 2316–2321. doi: 10.1002/cncr.11801

Author Information

  1. John Wayne Cancer Institute, Saint John's Hospital and Health Center, Santa Monica, California

  1. †

    Fax (310) 998-3995

*Department of Surgical Oncology, John Wayne Cancer Institute, 2200 Santa Monica Blvd., Santa Monica, CA 90404

Publication History

  1. Issue published online: 17 NOV 2003
  2. Article first published online: 7 OCT 2003
  3. Manuscript Accepted: 20 AUG 2003
  4. Manuscript Revised: 15 AUG 2003
  5. Manuscript Received: 16 JUN 2003

Funded by

  • Ben B. and Joyce E. Eisenberg Foundation (Los Angeles, CA)
  • Fashion Footwear Association of New York Charitable Foundation (New York, NY)
  • Leslie and Susan Gonda (Goldschmied) Foundation (Los Angeles, CA)
  • John Wayne Cancer Institute Auxiliary (Santa Monica, CA)
  • Rabinovitch Foundation (Beverly Hills, CA)
  • Witherbee Foundation (Santa Monica, CA)

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (151K)

Keywords:

  • mastectomy;
  • breast neoplasms;
  • mammaplasty;
  • physician's practice patterns

Abstract

BACKGROUND

Skin-sparing mastectomy (SSM) is a variation of modified radical mastectomy (MRM) optimized for reconstruction. The authors attempted to determine SSM attitudes and biases within different specialties and countries throughout the world.

METHODS

The authors polled 11,485 individuals via e-mail, including members of surgical, medical, and breast oncology societies, about SSM. Respondents were directed to a survey website where data were directly entered into a database.

RESULTS

Among 1027 respondents, 19 said their knowledge was insufficient to attempt the survey. Surveys were completed by 1008 respondents (8.8%) from 52 countries, comprising 436 (43.3%) surgeons, 376 (37.3%) medical oncologists, 146 (14.5%) radiation oncologists, and 50 (5.0%) individuals from other fields. Of the respondents, 61.9% stated that SSMs are performed at their institution. However 19.1% of these believed that SSM leaves the nipple and areola intact. This perception was higher outside the U.S. (P < 0.0001). Despite knowledge by 77.8% that SSM does not have a higher local disease recurrence rate than MRM, 25.3% of these individuals did not believe the literature. This was most prevalent among radiation oncologists (48.5%), as was the belief that SSM is contraindicated in patients with ductal carcinoma in situ and invasive breast carcinoma (23.3%).

CONCLUSIONS

Despite a developing body of literature, there was variation in opinion among specialties and a lack of understanding of SSM. Many physicians were not familiar with the literature. Among those who were, skepticism was highest among radiation oncologists. Although these results were indicative of only those responding, education about SSM is needed across specialties and in other countries if the procedure is to be widely accepted. Cancer 2003. © 2003 American Cancer Society.

View Full Article (HTML) Get PDF (151K)