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Awareness of residents’ technical ability can affect margin status in breast conserving operations

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Abstract

Purpose

The current study was performed to determine if awareness of the potential affect of residents could affect margin status.

Methods

Retrospective review of all patients who underwent lumpectomy from July 2006 to May 2017 was evaluated. The effect of surgical residents’ participation and their technical ability was evaluated to determine the effect on margin status. Logistic regression analysis was performed to determined factors which affect margin status.

Results

Of 444 patients, 14% of patients had positive margins. The positive margin rate was lower during the second time period after the effect of technical ability of the residents was known 12% versus 19% (p = 0.10). Greater participation by the attending surgeon (32% vs. 21%) occurred in the second time period. In multivariate logistic regression analysis, operations done by residents with satisfactory technical skills or attending surgeon were less likely to have positive margins than those done by residents with unsatisfactory technical skills (OR 0.19, 95% CI 0.10–0.38; p = 0.0001). With mean follow-up of 48 months, 1.4% had local recurrences as a first event.

Conclusions

Technically ability of residents appears to affect margin status after lumpectomy. Increased intervention by the attending surgeon can improve this outcome.

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Authors and Affiliations

  1. Department of Surgery, Maricopa Medical Center, Hogan Building, 2nd Floor, 2601 E Roosevelt Street, Phoenix, AZ, 85008, USA

    Joel VanderVelde, Jarvis W. Walters, Elizabeth M. N. Ferguson, Daniel M. Caruso & Ian K. Komenaka

  2. Arizona Cancer Center, University of Arizona, Tucson, AZ, USA

    Chiu-Hsieh Hsu & Ian K. Komenaka

  3. Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, AZ, USA

    Chiu-Hsieh Hsu

  4. Arizona State University, Phoenix, AZ, USA

    Jennifer Lee

Authors
  1. Joel VanderVelde
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  2. Jarvis W. Walters
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  3. Chiu-Hsieh Hsu
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  4. Elizabeth M. N. Ferguson
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  5. Jennifer Lee
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  6. Daniel M. Caruso
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  7. Ian K. Komenaka
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Corresponding author

Correspondence to Ian K. Komenaka.

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All authors declare that they have no conflict of interest.

Ethical approval

This retrospective study was approved by the Institutional Review Board.

Research involving human and animal participants

This article does not contain any studies with human participants or animals performed by any of the authors.

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Not applicable as this was a retrospective study.

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VanderVelde, J., Walters, J.W., Hsu, CH. et al. Awareness of residents’ technical ability can affect margin status in breast conserving operations. Breast Cancer Res Treat 177, 561–568 (2019). https://doi.org/10.1007/s10549-019-05344-3

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  • DOI: https://doi.org/10.1007/s10549-019-05344-3

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