Implementation of a Breast Intraoperative Oncoplastic Form to Aid Management of Oncoplastic Surgery

Amy E Li; Sachin Jhawar; Valarie Grignol; Doreen Agnese; Bridget A Oppong; Sasha Beyer; Jose G Bazan; Roman Skoracki; Chengli Shen; Ko Un Park

doi:10.1016/j.jss.2023.04.002

Implementation of a Breast Intraoperative Oncoplastic Form to Aid Management of Oncoplastic Surgery

J Surg Res. 2023 Oct:290:9-15. doi: 10.1016/j.jss.2023.04.002. Epub 2023 May 8.

Authors

Affiliations

¹ Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
² Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
³ Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio; Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, California.
⁴ Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
⁵ Department of Surgery, University of Virginia, Charlottesville, Virginia.
⁶ Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts. Electronic address: kpark16@bwh.harvard.edu.

PMID: 37163831
DOI: 10.1016/j.jss.2023.04.002

Abstract

Introduction: Oncoplastic breast conservation surgery (BCS) uses concurrent reduction and/or mastopexy with lumpectomy to improve aesthetic outcomes. However, tissue rearrangement can shift the original tumor location site in relation to external breast landmarks, resulting in difficulties during re-excision for a positive margin and accurate radiation targeting. We developed the Breast Intraoperative Oncoplastic (BIO) form to help depict the location of the tumor and breast reduction specimen. This study seeks to assess physician perspectives of the implementation outcomes.

Methods: From February 2021 to April 2021, the BIO form was used in 11 oncoplastic BCS cases at a single institution. With institutional review board approval, surgical oncologists (SOs), plastic surgeons (PSs), and radiation oncologists (ROs) were administered a 12-question validated survey on Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM), using a 5-point Likert scale during initial implementation and at 6-month reassessment.

Results: Twelve physicians completed the survey initially (4 SOs, 4 PSs, and 4 ROs). The mean scores for Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure were high (4.44, 4.56, and 4.56, respectively). Twelve completed the second survey (5 SOs, 3 PSs, and 4 ROs). The mean scores were marginally lower (4.06, 4.21, and 4.25). There were no significant differences when stratified by number of years in practice or specialty. Free text comments showed that 75% of physicians found the form helpful in oncoplastic BCS.

Conclusions: The data indicate high feasibility, acceptability, and appropriateness of the BIO form. Results of this study suggest multidisciplinary benefits of implementing the BIO form in oncoplastic BCS.

Keywords: Breast cancer; Lumpectomy; Oncoplastic breast surgery; Radiation therapy.

MeSH terms

Mammaplasty* / methods
Mastectomy*
Mastectomy, Segmental / methods
Reactive Oxygen Species
Retrospective Studies

Substances

Reactive Oxygen Species