Knowledge gaps in oncoplastic breast surgery - 04/08/20
, Monica Morrow, MD f, Jana de Boniface, MD g, h, Andrea Pusic, ProfMD i, Giacomo Montagna, MD a, d, f, Elisabeth A Kappos, MD a, c, Mathilde Ritter, MD a, c, Martin Haug, MD a, c, Christian Kurzeder, MD a, d, Ramon Saccilotto, MD b, Alexandra Schulz, MSc b, John Benson, MD j, k, Florian Fitzal, MD l, Zoltan Matrai, MD m, Jane Shaw, BA e, Marie-Jeanne Vrancken Peeters, ProfMD n, Shelley Potter, PhD o, p, Joerg Heil, MD qon behalf of the
Oncoplastic Breast Consortium†
Abstract |
The aims of the Oncoplastic Breast Consortium initiative were to identify important knowledge gaps in the field of oncoplastic breast-conserving surgery and nipple-sparing or skin-sparing mastectomy with immediate breast reconstruction, and to recommend appropriate research strategies to address these gaps. A total of 212 surgeons and 26 patient advocates from 55 countries prioritised the 15 most important knowledge gaps from a list of 38 in two electronic Delphi rounds. An interdisciplinary panel of the Oncoplastic Breast Consortium consisting of 63 stakeholders from 20 countries obtained consensus during an in-person meeting to select seven of these 15 knowledge gaps as research priorities. Three key recommendations emerged from the meeting. First, the effect of oncoplastic breast-conserving surgery on quality of life and the optimal type and timing of reconstruction after nipple-sparing or skin-sparing mastectomy with planned radiotherapy should be addressed by prospective cohort studies at an international level. Second, the role of adjunctive mesh and the positioning of implants during implant-based breast reconstruction should ideally be investigated by randomised controlled trials of pragmatic design. Finally, the BREAST-Q questionnaire is a suitable tool to assess primary outcomes in these studies, but other metrics to measure patient-reported outcomes should be systematically evaluated and quality indicators of surgical morbidity should be further assessed.
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Vol 21 - N° 8
P. e375-e385 - août 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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