Oncological screening for Bilateral Breast Reduction: a survey of practice variations in UK Breast and Plastics surgeons 2009.

ABSTRACT

INTRODUCTION: Bilateral Breast Reduction (BBR) is a common procedure performed by Breast and Plastic surgeons in the UK. No consensus exists regarding preoperative screening for malignancy or for selective criteria for such screening. Preoperative BBR screening practices among UK Breast and Plastic surgeons are unknown. AIMS: Ascertain the preoperative and postoperative BBR screening practices of UK Breast and Plastic surgeons. MATERIALS AND METHODS: A questionnaire was posted to all 434 Breast and 335 Plastic surgeons in the UK. All results were analysed with relevant statistical methods. KEY RESULTS: 64% of Breast surgeons and 72% of Plastic surgeons responded. 40% of Breast surgeons and 91% of Plastic surgeons perform BBR. Routine radiological screening 92% Breast 41% Plastic (p < 0.05). Routine breast examination prior to BBR 98% Breast 91% Plastic. Routine histology for BBR specimens 96% Breast 90% Plastic. Selective screening of patients aged 30-40 years old Breast 38% Plastic 10%. Selective screening of patients aged 40-50 Breast 78%, Plastic 53%. Selective screening of patients with strong family history of breast cancer Breast 72%, Plastic 91%. Selective screening of patients with previous breast cancer Breast 77%, Plastic 93%. CONCLUSIONS: There are significant differences in practice between UK Breast surgeons and Plastic surgeons in preoperative oncological screening for BBR. The large discrepancy in preoperative radiological screening, reflects a ubiquitous pro-screening ideology among Breast surgeons not prevalent among Plastic surgeons. These results will provoke debate towards the direction of consensus to ultimately reflect best practice.