Abstract P4-17-04: Results of the continuing education program in oncoplasty and breast reconstruction of the Brazilian Society of Mastology at Araujo Jorge Hospital in Goiania
Authors: Paulinelli RR , Filho JWCM , Ribeiro LFJ , Freitas-Junior R , Urban CA 
Published: March 2017

Abstract
Oncoplastic and reconstructive surgery is an important part of the treatment of breast cancer. In Brazil there is a specialization in Mastology since 1978, fully dedicated to manage all diseases of the breast. There are 2 years of specific residence training, after specialization in General Surgery or Gynecology. Incorporation of the reconstructive surgery is not uniform among all Breast Units around Brazil. Therefore, the Brazilian Society of Mastology has created an official program of continuing education.
Objective: To evaluate the effectiveness of a Hands On Educational Program in Oncoplasty and Breast Reconstruction of the Brazilian Society of Mastology at the Hospital Araújo Jorge, in Goiânia, in 2015.
Materials and Methods: Twelve mastologists were selected as trainees, based on the curriculum score. The program was divided into 10 monthly modules of two days (24h), with 25% of theory and a 75% of surgery. Activities were coordinated by two local and two invited teachers. The effectiveness was measured via an on-line questionnaire. To measure the improvement in medical practice it was used the modified classification of Urban and Lebovic, for the complexity of the reconstructive procedures. They were considered as class 1: monolateral partial reconstructions, esthetic incisions, periareolar de-epidermization, local reshaping; class 2: bilateral procedures, nipple-areolar reconstruction, lipofilling, breast augmentation, mastopexy; class 3: reconstruction with expanders or implants; class 4: myocutaneous flaps. Statistical analysis was performed by SPSS. It was significant a p&lt;0.05. Results: Twelve mastologists participated, with a mean age of 42.92 (+10.27). They performed 213 procedures, in 88 patients, using the main techniques for breast reconstruction. All students declared themselves satisfied with the course and they would indicate it to others. At the beginning, most students had some experience in local flaps. Half of the students referred trouble in finding other colleagues that could perform the reconstructions. At the end, most students declared themselves confortable to perform partial or total reconstruction of the breast with local flaps, mammaplasties, fat grafting, expanders and implants. Most of them were comfortable to resolve their own complications. More than a third were safe in performing miocutaneous flaps. All mastologists said to be interested in continuing technical improvement in different ways.
Table 1. Type of procedures usually executed by the trainees according to the modified Urban classification, before and after the course. Before the courseAfter the coursepClass 18 (80%)10 (83%)&lt;0.01Class 21 (10%)9 (75%) Class 31 (10%)12 (100%) Class 41 (10%)5 (42%) Cosmetic breast reductions or augmentation0 (0%)3 (25%)
Table 2. Proportion of oncoplastic and reconstrutive procedures executed by trainees, in clinical practice, before and after the course. BeforeAfterpNone4 (36%)0 (0%)&lt;0.01&lt;25%4 (36%)0 (0%) 26 - 50%2 (18%)2 (18%) 51 - 75%0 (0%)3 (27%) &gt;75%0 (0%)4 (36%) 100%1 (9%)2 (18%)
Conclusion: The current program in Goiania benefited many patients and brought a great contribution to the training of the participants.
Citation Format: Paulinelli RR, Filho JWCM, Ribeiro LFJ, Freitas-Junior R, Urban CA. Results of the continuing education program in oncoplasty and breast reconstruction of the Brazilian Society of Mastology at Araujo Jorge Hospital in Goiania [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-17-04.