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Breast Cancer Screening Prior to Cosmetic Breast Surgery: ASPS Members’ Adherence to American Cancer Society Guidelines

Selber, Jesse C. M.D., M.P.H.; Nelson, Jonas A. B.A.; Ashana, Adedayo O. B.A.; Bergey, Meredith R. M.Sc., M.P.H.; Bristol, Mirar N. M.A.; Sonnad, Seema S. Ph.D.; Serletti, Joseph M. M.D.; Wu, Liza C. M.D.

Plastic and Reconstructive Surgery: November 2009 - Volume 124 - Issue 5 - p 1375-1385
doi: 10.1097/PRS.0b013e3181b988c4
Breast: Original Articles

Background: The goal of this study was to determine the self-reported breast cancer screening practices of American plastic surgeons and the degree to which those practices adhere to the American Cancer Society guidelines. An independent analysis of subgroups divided by gender, years in practice, and practice setting was performed and the implications of the results are discussed.

Methods: The authors conducted an online survey of the members of the American Society of Plastic Surgeons. Questions assessed practice composition, American Cancer Society guideline familiarity, and preoperative breast cancer screening in patients seeking aesthetic breast surgery. Responses were summarized, subgroup comparisons were made, and logistic regression was used to determine predictors of physician practices.

Results: The 1066 respondents were predominantly male (82 percent) and consisted largely of private practitioners (73 percent). In total, 47 percent appeared to follow the American Cancer Society guidelines, while 64 percent claimed familiarity. Being male predicted more accurate guideline knowledge, but being female resulted in more aggressive screening and possibly more diagnoses. Number of years in practice and familiarity with the American Cancer Society guidelines also resulted in more perioperative diagnoses.

Conclusions: Knowledge of the American Cancer Society guidelines is an essential component of effective cancer screening, but only two-thirds of plastic surgeons claim familiarity with them, and fewer than half report concordant practices. As plastic surgeons who often perform surgical procedures on the breast in women with no history of breast disease, we have an obligation to understand and apply consistent, reliable breast cancer screening practices to ensure the well-being of our patients.

Philadelphia, Pa.

From the Division of Plastic Surgery, University of Pennsylvania.

Received for publication November 26, 2008; accepted April 9, 2009.

Disclosures: No authors involved in the production of this article have any commercial associations that might pose or create a conflict of interest with information presented herein. No intramural or extramural funding supported any aspect of this work.

Liza C. Wu, M.D., Division of Plastic Surgery, University of Pennsylvania, 10 Penn Tower, 3400 Spruce Street, Philadelphia, Pa. 19104,

©2009American Society of Plastic Surgeons