J. Redeker

Zertifizierte Brustzentren in Deutschland@@@Certified breast centers in Germany: Beteiligung der Plastischen Chirurgie@@@How much is plastic surgery involved?

ZusammenfassungHintergrundDiese Arbeit soll den aktuellen Stand der Kooperation zwischen Plastischen Chirurgen und Gynäkologen in zertifizierten Brustzentren darstellen. Die Rate der Brustrekonstruktionen nach nichtbrusterhaltender Therapie ist mit 8–13% sehr niedrig. Der Plastische Chirurg ist auch bei zertifizierten Brustzentren häufig nicht Teil des Teams.MethodenÜber das Westdeutsche Brustzentrum (WBC) wurden 220 im Jahr 2007 an das WBC angeschlossene Kliniken angeschrieben. 80 Kliniken schickten einen Fragebogen zurück. Die Untersuchung basiert auf den Daten von ca. 24.000 Patientinnen.ErgebnisseVon den 80 Kliniken waren zum Zeitpunkt der Untersuchung 60 Kliniken (75%) als Brustzentrum zertifiziert. Die Zertifizierung erfolgte nach unterschiedlichen Vorgaben: Land Nordrhein-Westfalen, DKG/DGS (Deutsche Krebsgesellschaft/Deutsche Gesellschaft für Senologie), EUSOMA, andere. In 8 Kliniken (10%) wurde ein Plastischer Chirurg als operativ tätiger Facharzt und Teil des Brustzentrums benannt. Die meisten Brustzentren (44 von 80 Kliniken) arbeiten mit 3 bis 4 operativ tätigen Fachärzten.DiskussionDie Zusammenarbeit innerhalb eines Brustzentrums zwischen Gynäkologen und Plastischen Chirurgen kann ausgebaut werden. Nicht jede Frau braucht nach einer Mastektomie einen (mikrochirurgischen) Brustaufbau, aber jede betroffene Frau hat das Recht auf eine Aufklärung über alle zur Verfügung stehenden Rekonstruktionsverfahren inklusive der mikrochirurgischen Verfahren.AbstractIntroductionThis study was designed to assess the degree of cooperation between plastic surgeons and gynecologists in certified breast centers in Germany. The rate of breast reconstruction after mastectomy remains low at 8–13%. In certified breast centers plastic surgeons are often not members of the team.MethodsA total of 220 hospitals affiliated to the West German Breast Center (WBC) were contacted in 2007 and 80 breast centers and hospitals returned the questionnaire. This study is based on the data of approximately 24,000 patients.ResultsAt the time of the investigation 60 out of the 80 hospitals (75%) were certified breast centers. Many different criteria have been applied for certified breast centers: the state of Nordrhein-Westfalen, the DKG/DGS (German Cancer Society/German Society of Senology), EUSOMA and others. In 8 hospitals (10%) a plastic surgeon was part of the team in the breast center. Most breast centers (44 out of 80) function with 3–4 attending specialists for breast surgery.DiscussionThe cooperation between gynecologists and plastic surgeons within a breast center can be strengthened. A microsurgical breast augmentation is not the ideal solution for every patient with a mastectomy but every patient has the right to obtain complete information about the whole spectrum of breast reconstruction including microsurgical free flap reconstruction.INTRODUCTION This study was designed to assess the degree of cooperation between plastic surgeons and gynecologists in certified breast centers in Germany. The rate of breast reconstruction after mastectomy remains low at 8-13%. In certified breast centers plastic surgeons are often not members of the team. METHODS A total of 220 hospitals affiliated to the West German Breast Center (WBC) were contacted in 2007 and 80 breast centers and hospitals returned the questionnaire. This study is based on the data of approximately 24,000 patients. RESULTS At the time of the investigation 60 out of the 80 hospitals (75%) were certified breast centers. Many different criteria have been applied for certified breast centers: the state of Nordrhein-Westfalen, the DKG/DGS (German Cancer Society/German Society of Senology), EUSOMA and others. In 8 hospitals (10%) a plastic surgeon was part of the team in the breast center. Most breast centers (44 out of 80) function with 3-4 attending specialists for breast surgery. DISCUSSION The cooperation between gynecologists and plastic surgeons within a breast center can be strengthened. A microsurgical breast augmentation is not the ideal solution for every patient with a mastectomy but every patient has the right to obtain complete information about the whole spectrum of breast reconstruction including microsurgical free flap reconstruction.

[Certified breast centers in Germany : How much is plastic surgery involved?].

ZusammenfassungHintergrundDiese Arbeit soll den aktuellen Stand der Kooperation zwischen Plastischen Chirurgen und Gynäkologen in zertifizierten Brustzentren darstellen. Die Rate der Brustrekonstruktionen nach nichtbrusterhaltender Therapie ist mit 8–13% sehr niedrig. Der Plastische Chirurg ist auch bei zertifizierten Brustzentren häufig nicht Teil des Teams.MethodenÜber das Westdeutsche Brustzentrum (WBC) wurden 220 im Jahr 2007 an das WBC angeschlossene Kliniken angeschrieben. 80 Kliniken schickten einen Fragebogen zurück. Die Untersuchung basiert auf den Daten von ca. 24.000 Patientinnen.ErgebnisseVon den 80 Kliniken waren zum Zeitpunkt der Untersuchung 60 Kliniken (75%) als Brustzentrum zertifiziert. Die Zertifizierung erfolgte nach unterschiedlichen Vorgaben: Land Nordrhein-Westfalen, DKG/DGS (Deutsche Krebsgesellschaft/Deutsche Gesellschaft für Senologie), EUSOMA, andere. In 8 Kliniken (10%) wurde ein Plastischer Chirurg als operativ tätiger Facharzt und Teil des Brustzentrums benannt. Die meisten Brustzentren (44 von 80 Kliniken) arbeiten mit 3 bis 4 operativ tätigen Fachärzten.DiskussionDie Zusammenarbeit innerhalb eines Brustzentrums zwischen Gynäkologen und Plastischen Chirurgen kann ausgebaut werden. Nicht jede Frau braucht nach einer Mastektomie einen (mikrochirurgischen) Brustaufbau, aber jede betroffene Frau hat das Recht auf eine Aufklärung über alle zur Verfügung stehenden Rekonstruktionsverfahren inklusive der mikrochirurgischen Verfahren.AbstractIntroductionThis study was designed to assess the degree of cooperation between plastic surgeons and gynecologists in certified breast centers in Germany. The rate of breast reconstruction after mastectomy remains low at 8–13%. In certified breast centers plastic surgeons are often not members of the team.MethodsA total of 220 hospitals affiliated to the West German Breast Center (WBC) were contacted in 2007 and 80 breast centers and hospitals returned the questionnaire. This study is based on the data of approximately 24,000 patients.ResultsAt the time of the investigation 60 out of the 80 hospitals (75%) were certified breast centers. Many different criteria have been applied for certified breast centers: the state of Nordrhein-Westfalen, the DKG/DGS (German Cancer Society/German Society of Senology), EUSOMA and others. In 8 hospitals (10%) a plastic surgeon was part of the team in the breast center. Most breast centers (44 out of 80) function with 3–4 attending specialists for breast surgery.DiscussionThe cooperation between gynecologists and plastic surgeons within a breast center can be strengthened. A microsurgical breast augmentation is not the ideal solution for every patient with a mastectomy but every patient has the right to obtain complete information about the whole spectrum of breast reconstruction including microsurgical free flap reconstruction.INTRODUCTION This study was designed to assess the degree of cooperation between plastic surgeons and gynecologists in certified breast centers in Germany. The rate of breast reconstruction after mastectomy remains low at 8-13%. In certified breast centers plastic surgeons are often not members of the team. METHODS A total of 220 hospitals affiliated to the West German Breast Center (WBC) were contacted in 2007 and 80 breast centers and hospitals returned the questionnaire. This study is based on the data of approximately 24,000 patients. RESULTS At the time of the investigation 60 out of the 80 hospitals (75%) were certified breast centers. Many different criteria have been applied for certified breast centers: the state of Nordrhein-Westfalen, the DKG/DGS (German Cancer Society/German Society of Senology), EUSOMA and others. In 8 hospitals (10%) a plastic surgeon was part of the team in the breast center. Most breast centers (44 out of 80) function with 3-4 attending specialists for breast surgery. DISCUSSION The cooperation between gynecologists and plastic surgeons within a breast center can be strengthened. A microsurgical breast augmentation is not the ideal solution for every patient with a mastectomy but every patient has the right to obtain complete information about the whole spectrum of breast reconstruction including microsurgical free flap reconstruction.