ESPRAS Survey on Breast Reconstruction in Europe

 

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Abstract

Background The European Leadership Forum (ELF) of the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) previously identified the need for harmonisation of breast reconstruction standards in Europe, in order to strengthen the role of plastic surgeons. This study aims to survey the status, current trends and potential regional differences in the practice of breast reconstruction in Europe, with emphasis on equity and access.

Materials and Methods A largescale web-based questionnaire was sent to consultant plastic and reconstructive surgeons, who are experienced in breast reconstruction and with understanding of the national situation in their country. Suitable participants were identified via the Executive Committee (ExCo) of ESPRAS and national delegates of ESPRAS. The results were evaluated and related to evidence-based literature.

Results A total of 33 participants from 29 European countries participated in this study. Overall, the incidence of breast reconstruction was reported to be relatively low across Europe, comparable to other large geographic regions, such as North America. Equity of provision and access to breast reconstruction was distributed evenly within Europe, with geographic regions potentially affecting the type of reconstruction offered. Standard practices with regard to radiotherapy differed between countries and a clear demand for European guidelines on breast reconstruction was reported.

Conclusion This study identified distinct lack of consistency in international practice patterns across European countries and a strong demand for consistent European guidance. Large-scale and multi-centre European clinical trials are required to further elucidate the presented areas of interest and to define European standard operating procedures.

Zusammenfassung

Hintergrund Im Rahmen des ELF der ESPRAS wurde die Notwendigkeit standardisierter Richtlinien zur Brustrekonstruktion auf europäischer Ebene definiert. Ziel dieser Studie ist es, zunächst einen Überblick über den aktuellen Status, Entwicklungen und mögliche regionale Unterschiede der Brustrekonstruktion in Europa zu geben, wobei ein Schwerpunkt auf dem Angebot, der Verteilung und dem Zugang zur Brustrekonstruktion liegt.

Materialien und Methoden Es erfolgte eine internetbasierte Befragung von in der Brustrekonstruktion spezialisierten Plastischen Chirurgen, welche zusätzlich die nationalen Versorgungsstrukturen ihrer jeweiligen Länder überblicken. Geeignete Teilnehmer wurden über das ExCo der ESPRAS und nationale Delegierte von ESPRAS identifiziert. Die Ergebnisse wurden mit aktueller evidenzbasierter Literatur verglichen.

Ergebnisse 33 Teilnehmer aus 29 europäischen Ländern nahmen an der Studie teil. Im Vergleich zur Gesamtzahl durchgeführter Mastektomien war die Inzidenz der Brustrekonstruktionen in Europa relativ gering, vergleichbar mit anderen großen geografischen Regionen, wie z. B. Nordamerika. Die Verfügbarkeit und der Zugang zur Brustrekonstruktion war innerhalb Europas gleichmäßig verteilt, allerdings kann die geografische Region das Verfahren der Brustrekonstruktion (Eigengewebe vs. Implantat) beeinflussen. Deutliche Differenzen zeigten sich bezüglich Brustrekonstruktionen bei bestrahlten Patientinnen.

Schlussfolgerung Die Studie identifizierte ein ausgeprägtes Maß an Inkohärenz in den internationalen Standards zwischen den europäischen Ländern. Es besteht großer Bedarf für kohärente europäische Leitlinien. Europäische, multizentrische klinische Studien sollten initiiert werden, um eine evidenzbasierte Grundlage zu schaffen.

Publication History

Received: 09 March 2021

Accepted: 10 March 2021

Article published online:
30 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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