Güldeniz Karadeniz Çakmak1, Selman Emiroğlu2, Atakan Sezer3, Nuh Zafer Canturk4, Levent Yeniay5, Bekir Kuru6, Hasan Karanlık7, Aykut Soyder8, Şehsuvar Gökgöz9, Gürhan Sakman10, Muhammed Ucuncu11, Mufide Nuran Akcay12, Sadullah Girgin13, Sibel Ozkan Gurdal14, Mustafa Emiroglu15, Serdar Ozbas16, Abdullah Bahadir Öz17, Cumhur Arici18, Osman Toktas19, Orhan Demircan20, Adnan Çalık21, Ayfer Kamali Polat6, Gokturk Maralcan22, Seher Demirer23, Vahit Ozmen2. 1. Department of Surgery, The School of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey. 2. Department of Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey. 3. Department of Surgery, The School of Medicine, Trakya University, Edirne, Turkey. 4. Department of Surgery, The School of Medicine, Kocaeli University, Kocaeli, Turkey. 5. Department of Surgery, The School of Medicine, Ege University, Izmir, Turkey. 6. Department of Surgery, The School of Medicine, Ondokuz Mayıs University, Samsun, Turkey. 7. Oncology Institute, Istanbul University, Istanbul, Turkey. 8. Department of Surgery, The School of Medicine, Adnan Menderes University, Aydın, Turkey. 9. Department of Surgery, The School of Medicine, Uludag University, Bursa, Turkey. 10. Department of Surgery, The School of Medicine, Cukurova University, Adana, Turkey. 11. Istanbul Florence Nightingale Hospital, Istanbul, Turkey. 12. Department of Surgery, The School of Medicine, Ataturk University, Erzurum, Turkey. 13. Department of Surgery, The School of Medicine, Dicle University, Diyarbakır, Turkey. 14. Department of Surgery, The School of Medicine, Namık Kemal University, Tekirdag, Turkey. 15. Izmir Tepecik Education and Research Hospital, Izmir, Turkey. 16. Guven Hospital, Ankara, Turkey. 17. Department of Surgery, The School of Medicine, Erciyes University, Kayseri, Turkey. 18. Department of Surgery, The School of Medicine, Akdeniz University, Antalya, Turkey. 19. Department of Surgery, The School of Medicine, Van Yüzüncü Yil University, Van, Turkey. 20. Acibadem Adana Hospital, Adana, Turkey. 21. Department of Surgery, The School of Medicine, Karadeniz Teknik University, Trabzon, Turkey. 22. Department of Surgery, The School of Medicine, Sanko University, Gaziantep, Turkey. 23. Department of Surgery, The School of Medicine, Ankara University, Ankara, Turkey.
Abstract
PURPOSE: Breast cancer is the most frequent cancer in women, and there is a great variability in surgical practice for treating that cancer in different countries. The aims of this study were to analyze the effect of guidelines from the Turkish Federation of Breast Diseases Societies on academic institutions that have breast centers and to evaluate surgical practice in Turkey in 2018. PATIENTS AND METHODS: Between January and March 2019, a survey was sent to breast surgeons who were working in breast centers in academic institutions. The sampling frame included 24 academic institutions with breast centers in 18 cities in Turkey to evaluate interdisciplinary differences among breast centers and seven regions in Turkey regarding patients' choices, surgical approaches, and academic institutions. RESULTS: All surgeons responded to the survey, and all 4,381 patients were included. Most of the surgeons (73.9%) were working in a breast center. Multidisciplinary tumor boards were performed in 87% of the breast centers. The average time between clinical evaluation and initiation of treatment was 29 days; the longest time was in Southeast Anatolia (66 days). Only 6% of patients had ductal carcinoma in situ. Sentinel lymph node biopsy was available in every region across the country and was performed in 64.5% of the patients. In 2018, the overall breast-conserving surgery rate was 57.3% in Turkey, and it varied from 72.2% in the Black Sea region to 33.5% in Central Anatolia (P < .001). Oncoplastic breast surgery options were available at all breast centers. However, 25% of the breast centers from the Black Sea region and half the breast centers from Eastern Anatolia and the Mediterranean region did not perform this type of surgery. CONCLUSION: Increasing rates of nonpalpable breast cancer and decreasing rates of locoregional recurrences favored breast-conserving surgery, especially in developed countries. Guidelines from the Turkish Federation of Breast Diseases Societies resulted in more comprehensive breast centers and improved breast health in Turkey.
PURPOSE:Breast cancer is the most frequent cancer in women, and there is a great variability in surgical practice for treating that cancer in different countries. The aims of this study were to analyze the effect of guidelines from the Turkish Federation of Breast Diseases Societies on academic institutions that have breast centers and to evaluate surgical practice in Turkey in 2018. PATIENTS AND METHODS: Between January and March 2019, a survey was sent to breast surgeons who were working in breast centers in academic institutions. The sampling frame included 24 academic institutions with breast centers in 18 cities in Turkey to evaluate interdisciplinary differences among breast centers and seven regions in Turkey regarding patients' choices, surgical approaches, and academic institutions. RESULTS: All surgeons responded to the survey, and all 4,381 patients were included. Most of the surgeons (73.9%) were working in a breast center. Multidisciplinary tumor boards were performed in 87% of the breast centers. The average time between clinical evaluation and initiation of treatment was 29 days; the longest time was in Southeast Anatolia (66 days). Only 6% of patients had ductal carcinoma in situ. Sentinel lymph node biopsy was available in every region across the country and was performed in 64.5% of the patients. In 2018, the overall breast-conserving surgery rate was 57.3% in Turkey, and it varied from 72.2% in the Black Sea region to 33.5% in Central Anatolia (P < .001). Oncoplastic breast surgery options were available at all breast centers. However, 25% of the breast centers from the Black Sea region and half the breast centers from Eastern Anatolia and the Mediterranean region did not perform this type of surgery. CONCLUSION: Increasing rates of nonpalpable breast cancer and decreasing rates of locoregional recurrences favored breast-conserving surgery, especially in developed countries. Guidelines from the Turkish Federation of Breast Diseases Societies resulted in more comprehensive breast centers and improved breast health in Turkey.
Authors: L N van Steenbergen; L V van de Poll-Franse; M W J M Wouters; M L E A Jansen-Landheer; J W W Coebergh; H Struikmans; V C G Tjan-Heijnen; C J H van de Velde Journal: Eur J Surg Oncol Date: 2010-09 Impact factor: 4.424
Authors: Mila Donker; Geertjan van Tienhoven; Marieke E Straver; Philip Meijnen; Cornelis J H van de Velde; Robert E Mansel; Luigi Cataliotti; A Helen Westenberg; Jean H G Klinkenbijl; Lorenzo Orzalesi; Willem H Bouma; Huub C J van der Mijle; Grard A P Nieuwenhuijzen; Sanne C Veltkamp; Leen Slaets; Nicole J Duez; Peter W de Graaf; Thijs van Dalen; Andreas Marinelli; Herman Rijna; Marko Snoj; Nigel J Bundred; Jos W S Merkus; Yazid Belkacemi; Patrick Petignat; Dominic A X Schinagl; Corneel Coens; Carlo G M Messina; Jan Bogaerts; Emiel J T Rutgers Journal: Lancet Oncol Date: 2014-10-15 Impact factor: 41.316
Authors: John D Birkmeyer; Bradley N Reames; Peter McCulloch; Andrew J Carr; W Bruce Campbell; John E Wennberg Journal: Lancet Date: 2013-09-28 Impact factor: 79.321
Authors: David W Ollila; E Shelley Hwang; David R Brenin; Henry M Kuerer; Katharine Yao; Sheldon Feldman Journal: Ann Surg Oncol Date: 2018-07-02 Impact factor: 5.344