Teaching residents may affect the margin status of breast-conserving operations

Gina R. Shirah, Chiu-Hsieh Hsu, Meredith A. Heberer, Lauren I. Wikholm, Jonathan J. Goodman, Marcia E. Bouton, Ian K. Komenaka

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: The current study was performed to evaluate the effects of teaching surgical residents on the margin status after lumpectomy. Methods: A retrospective review of all patients from July 2006 to Nov 2009 was performed. The impact of the technical ability of surgical residents to perform lumpectomy was evaluated to determine if there was an effect on the margin status. A logistic regression analysis was performed to adjust for clinical variables known to affect the margin status. Results: Of 106 patients, 19 % had positive margins. Residents with unsatisfactory technical skills had a positive margin rate of 34 % compared to 8 % for residents with satisfactory skills (p = 0.004). In the multivariate logistic regression analysis, the operating surgeon remained significantly associated with a positive margin status. Operations performed by residents with satisfactory technical skills or by attending surgeons were less likely to have positive margins than those performed by residents with unsatisfactory technical skills (OR 0.26, 95 % CI 0.08–0.86; p = 0.03). After a mean follow-up of 60 months, the breast cancer-specific survival rate was 94 %, and there were no local recurrences as a first event. Conclusions: The technical ability of residents may affect the margin status after lumpectomy. The importance of teaching surgical residents needs to be considered in future quality of care evaluations.

Original languageEnglish (US)
Pages (from-to)437-444
Number of pages8
JournalSurgery Today
Volume46
Issue number4
DOIs
StatePublished - Apr 1 2016

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Segmental Mastectomy
Teaching
Breast
Logistic Models
Regression Analysis
Quality of Health Care
Survival Rate
Breast Neoplasms
Recurrence
Surgeons

Keywords

  • Lumpectomy
  • Margin
  • Resident
  • Teaching
  • Technical ability

ASJC Scopus subject areas

  • Surgery

Cite this

Shirah, G. R., Hsu, C-H., Heberer, M. A., Wikholm, L. I., Goodman, J. J., Bouton, M. E., & Komenaka, I. K. (2016). Teaching residents may affect the margin status of breast-conserving operations. Surgery Today, 46(4), 437-444. https://doi.org/10.1007/s00595-015-1184-5

Teaching residents may affect the margin status of breast-conserving operations. / Shirah, Gina R.; Hsu, Chiu-Hsieh; Heberer, Meredith A.; Wikholm, Lauren I.; Goodman, Jonathan J.; Bouton, Marcia E.; Komenaka, Ian K.

In: Surgery Today, Vol. 46, No. 4, 01.04.2016, p. 437-444.

Research output: Contribution to journalArticle

Shirah, GR, Hsu, C-H, Heberer, MA, Wikholm, LI, Goodman, JJ, Bouton, ME & Komenaka, IK 2016, 'Teaching residents may affect the margin status of breast-conserving operations', Surgery Today, vol. 46, no. 4, pp. 437-444. https://doi.org/10.1007/s00595-015-1184-5
Shirah, Gina R. ; Hsu, Chiu-Hsieh ; Heberer, Meredith A. ; Wikholm, Lauren I. ; Goodman, Jonathan J. ; Bouton, Marcia E. ; Komenaka, Ian K. / Teaching residents may affect the margin status of breast-conserving operations. In: Surgery Today. 2016 ; Vol. 46, No. 4. pp. 437-444.
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