Abstract:
BACKGROUND:Health care reform places primary care (PC) physicians in an increasingly significant role for breast cancer screening and diagnosis. This study assessed the adequacy of traditional PC resident training to prepare physicians for this front-line role. METHODS:Sixty-eight primary care residents, representing seven training programs, participated in a multidimensional needs assessment study of clinical breast evaluation skills. RESULTS:Performance deficiencies noted in each component were most significant in (1) common breast problem management (problem-solving mean 44.51 +/- 11.01); (2) breast examination skills (mean 49.65 +/- 14.48%); and (3) lump detection sensitivity (mean 40.20 +/- 17.10%). Overall examination reliability was good (alpha = .82). Factorial ANOVA revealed significant performance differences among training programs. Residency programs with higher performance levels reported dedicated breast curricula, and residents rated these programs as providing more adequate training. Programs with poorer performance in breast examination lacked curriculum emphasis, with residents describing training received as poor to fair. CONCLUSION:This study demonstrated performance deficits in the clinical breast evaluation skills of graduating PC residents that have not been captured by traditional evaluation methodologies. This may represent a limitation in the ability of many PC physicians to effectively screen and diagnose patients with breast cancer.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Chalabian J,Formenti S,Russell C,Pearce J,Dunnington Gdoi
10.1007/BF02303850subject
Has Abstractpub_date
1998-03-01 00:00:00pages
166-72issue
2eissn
1068-9265issn
1534-4681journal_volume
5pub_type
杂志文章abstract:BACKGROUND:Inguinofemoral lymphadenectomy is associated with frequent and marked incision-related morbidity. Our initial feasibility study of videoscopic inguinal lymphadenectomy (VIL) for melanoma showed appropriate nodal yield and anatomic dissection. Although a limited suprafascial dissection has been reported in th...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1490-5
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:After introduction of the clamp-crushing technique in the 1970s, various devices have been developed for transection of the liver with the aim of further reducing blood loss and improving the outcome of patients who undergo hepatic resection. We performed a meta-analysis to quantitatively compare the clamp-c...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
doi:10.1245/s10434-008-0266-7
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:The locoregional recurrence (LRR) rate after mastectomy is reported to be similar with immediate reconstruction. We aimed to identify characteristics of LRR after transverse rectus abdominis myocutaneous (TRAM) reconstruction. METHODS:We retrospectively reviewed patients undergoing immediate TRAM reconstruc...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2329-z
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:To improve the poor prognosis of patients with advanced incurable gastric cancer, intensive chemotherapy combined with radical surgery was used. PATIENTS AND METHODS:Thirty patients with incurable gastric cancer were treated with a combination of 5-fluorouracil (370 mg/m2) and leucovorin (30 mg/person), giv...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1007/BF02306611
更新日期:1997-04-01 00:00:00
abstract:PURPOSE:To examine the association between the number of lymph nodes retrieved and oncologic outcome after preoperative chemoradiation for rectal cancer according to tumor regression grade. METHODS:Patients with rectal cancer who underwent curative surgery between May 2004 and December 2012 were analyzed retrospective...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4235-z
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Postoperative complications are associated with poor cancer-specific survival in various types of cancer surgery. Recent studies suggest that systemic inflammation induced by surgical trauma can accelerate the adhesion of circulating tumor cells to the vascular endothelium of distant organs, resulting in ear...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5655-8
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:The aim of this review was to examine the incidence of nipple-areola complex (NAC) involvement, the rates of NAC recurrence, and the data regarding the role of radiation therapy (RT) following nipple-sparing mastectomy (NSM). METHODS:A literature review was performed using the PubMed search engine, with articl...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-013-3446-z
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Laparoscopic liver resection for perihilar cholangiocarcinoma (pCCA) is still in its infancy. The biliary-enteric reconstruction represents one of the most delicate parts of this minimally invasive procedure. METHODS:In this study, a 78-year old woman with perihilar cholangiocarcinoma (pCCA) type 3b underwe...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09175-1
更新日期:2020-09-30 00:00:00
abstract:BACKGROUND:Chemotherapy is increasingly used before hepatic resection, with controversial impact regarding liver function. This study aimed to assess the capacity of 99mTc-labelled-mebrofenin SPECT-hepatobiliary scintigraphy (HBS) to predict liver dysfunction due to chemotherapy and/or chemotherapeutic-associated liver...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08988-4
更新日期:2020-08-24 00:00:00
abstract:BACKGROUND:Repeat sentinel lymph node biopsy (rSLNB) has increasingly been used in patients with ipsilateral breast tumor recurrence (IBTR). The safety in terms of regional disease control after this procedure remains unclear. This study evaluates occurrence of regional recurrence as first event in patients with IBTR a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6384-y
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:The main objective of this study was to determine whether there was a correlation in the levels of various angiogenesis-related factors between the tumor drainage and peripheral venous blood and whether appraisal of angiogenic factor levels in the tumor drainage venous blood could provide better prognostic i...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9042-8
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Whether breast cancer surgeons are adequately trained, skilled, and experienced to provide breast cancer genetic assessment, testing, and counseling came under debate in September 2013 when a major third-party payer excluded nongenetics specialists from ordering such testing. A literature search having faile...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3711-9
更新日期:2014-12-01 00:00:00
abstract::Malignant tumors of epithelial tissue are the most common form of cancer and are responsible for the majority of cancer-related deaths in Western industrialized countries. As a result of progress in surgical treatment of these tumors, lethality is linked increasingly to early metastasis, which is generally occult at t...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Surgery alone is often inadequate for advanced-stage gastric cancer. Surgical complications may delay adjuvant therapy. Understanding these complications is needed for multidisciplinary planning. MATERIAL AND METHODS:The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-014-3664-z
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Major hepatectomy for intrahepatic cholangiocarcinoma (ICC) sometimes involves resection of major hepatic veins, which might result in the future liver remnant (FLR) congestion. The necessity and efficacy of resection and reconstruction of the middle hepatic vein (MHV) during right or left hemihepatectomy fo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5384-z
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Understanding the natural progression of untreated gastric cancer is critical for determining the disease prognosis as well as treatment options and timing. The aim of this study is to analyze the natural history of gastric cancer. PATIENTS AND METHODS:We included patients with gastric cancer who had not re...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07455-z
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:The risk for occult neck nodal metastasis in carcinoma of the parotid gland is inconclusive. Therefore, addressing a negative neck prophylactically and the extent to do so remain controversial. This systematic review aimed to determine the rate of occult nodal metastasis for each neck level, and consequently...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-020-09331-7
更新日期:2020-11-11 00:00:00
abstract:BACKGROUND:Debate regarding axillary dissection in the treatment of women with small invasive cancers of the breast has been increasing. Recently, omission of axillary dissection has been proposed because of the reported low incidence of nodal metastases in women with such cancers. Variation in the incidence of nodal m...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1007/BF02303756
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Radiofrequency ablation (RFA) for the treatment of hepatic tumors has been increasingly used across the United States. Whether treatment-related morbidity has remained low with broader adoption is unclear. We conducted this study to describe in-hospital morbidity associated with RFA for hepatic tumors and to...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2397-0
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Arginine plays a pivotal role in regulating ureagenesis, polyamine biosynthesis, and nitric oxide production, metabolic pathways that may be stimulated in the liver of the tumor-bearing host. Normally, plasma arginine is excluded from the hepatocyte intracellular space by the low basal activity of its membra...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303559
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:The prognosis of patients with esophageal squamous-cell cancer (ESCC) and multiple lymph-node metastases is quite poor. We examined whether neoadjuvant chemoradiation therapy (CRT) has a beneficial effect in such patients. METHODS:A total of 50 consecutive patients with T3-4 tumors and without organ metasta...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3688-4
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Radiofrequency ablation (RFA) is being used to treat primary and metastatic liver tumors. The indications, treatment planning, and limitations of hepatic RFA must be defined and refined by surgeons treating hepatic malignancies. METHODS:A review of the experience using RFA to treat unresectable primary and ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/aso.2003.07.017
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:To appreciate if the ovaries can be preserved in selected young women with peritoneal carcinomatosis (PC). BACKGROUND:The traditional rule is to resect the ovaries systematically when PC is found at surgery. METHODS:A new policy was developed to preserve the ovaries when they were macroscopically normal in ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-2879-8
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Hepatic resection is potentially curative in selected patients with colorectal metastases. It is a widely held practice that multiple colorectal hepatic metastases are not resected, although outcome after removal of four or more metastases is not well defined. METHODS:Patients with four or more colorectal h...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-000-0643-3
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Malignant ascites (MA) is a distressing problem usually managed by repeated paracenteses. Paracentesis represents a meaningful time point in identifying patients with a specific presentation. OBJECTIVE:The objective of this study is to examine symptom clustering in MA patients at paracentesis. METHODS:Pre-...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0774-0
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:The value of p53 status for predicting response to chemotherapy-based treatment in patients with esophageal cancer has been controversial. We conducted a meta-analysis to elucidate the correlation of p53 status with the response to chemotherapy-based treatment. METHODS:Studies were searched in PubMed, Embas...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
doi:10.1245/s10434-012-2859-4
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:A significant proportion of women who have breast-conserving surgery (BCS) subsequently undergo re-excision or proceed to mastectomy. This study aimed to identify factors associated with residual disease after repeat surgery and to determine their effect on ipsilateral breast tumor recurrence (IBTR) and surv...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4707-9
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The biopsy method of choice for soft tissue sarcomas (STS) of the limb and limb girdle is controversial. There have been no randomized controlled trials that compare incision biopsy with Tru-cut biopsy. We present a large series, which includes an analysis of the effectiveness of Tru-cut core biopsy both in ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0080-y
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Breast cancer is increasingly detected during an early non-palpable stage. Together with pre-operative marking of the mass, intra-operative imaging provides invaluable clues. This study was designed to evaluate the usefulness of intra-operative sonography in the hands of the surgeon. METHODS:Between July 20...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9490-9
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Perioperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) is known to reduce inflammatory response in relation to surgery. Inflammation may promote recurrence of cancer, thus inhibition by use of NSAIDs could reduce recurrence after surgery. OBJECTIVE:The aim of this study was to examine the associ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07600-8
更新日期:2019-11-01 00:00:00