Cancer journal pulls deeply flawed meeting abstract on breast surgery

The European Journal of Surgical Oncology has retracted a meeting abstract that evidently was never meant to be.

The study, by researchers at Queen Elizabeth Hospital and Good Hope Hospital, both in Birmingham, England, was to be presented at this year’s annual meeting of the Association of Breast Surgery and purported to compare rates of patient satisfaction among women who underwent two kinds of breast reconstruction, TRAM — transverse rectus abdominis myocutaneous  — flap and DIEP (short for deep inferior epigastric perforators) flap.

But according to the notice:

This conference abstract has been retracted at the request of the authors. The research presented in the abstract was undertaken by the authors as a service review and subsequently submitted for presentation as a poster at the Association of Breast Surgery Conference, which took place on the 21st and 22nd May 2012. The authors accepted to present the poster at the Conference, but subsequently withdrew it. However, the abstract had already been published in the European Journal of Surgical Oncology, together with other abstracts from the conference.

The study did not receive ethical approval, and there is disagreement as to whether ethical approval was required. In addition, some patients included in the study were treated by a breast cancer surgeon currently under investigation for using a surgical technique not deemed to be best practice, which may have affected the results. The authors have therefore requested the retraction of this conference abstract and apologise to the readers of the European Journal of Surgical Oncology.

We think the surgeon under investigation might be Ian Paterson, whose patients are being studied for signs that the technique he used might put them at greater risk for metastasis, according to an undated NHS press release. Those surgeries took place at another Birmingham hospital. The release, which refers to a 2007 review, stated that:

The technique involved performing the mastectomy and leaving behind a small amount of residual breast tissue to assist in providing an improved cleavage for the patient. The Trust understands that this procedure was being carried out in good faith, believing it to be appropriate for patients, to achieve removal of the carcinoma, but with a better cosmetic result than a traditional mastectomy. This procedure was not performed on all patients undergoing mastectomy.

The review highlighted that this was not a usual procedure and the appropriate guidelines had not been followed to introduce this new technique. This Trust’s position, after careful consideration, was that the technique was not an approach considered appropriate going forward, and the method was therefore stopped.

We’ve tried to reach the editor of the journal for comment, and will update with anything we hear back.

Hat tip: Clare Francis

4 thoughts on “Cancer journal pulls deeply flawed meeting abstract on breast surgery”

  1. In the UK, service reviews (reviews of routinely collected operational and outcomes data collected by hospital departments about their patients) are normally regarded as ‘audit’ rather than ‘research’. This means that they are not subject to NHS Local Research Ethics Committee approval (LREC, equivalent to IRB approval in the US). The difficulty comes when clinicians seek to publish that data as though it was research, which is what seems to have happened here. If the abstract was based on audit, then it didn’t need LREC approval, but it also did not seek to answer a research question. The problem was not that the data was collected without ethics committee approval, but that it was then presented as research. This is doubtless an honest mistake, especially as the topic is self-reported patient satisfaction. About the Dr not conforming to ‘best practice’ I know nothing and cannot say.


    Ian Paterson: Surgeon wounded hundreds amid ‘culture of denial’

    An independent inquiry into Ian Paterson’s malpractice has recommended the recall of his 11,000 patients for their surgery to be assessed.

    Paterson is serving a 20-year jail term for 17 counts of wounding with intent.

    One of Paterson’s colleagues has been referred to police and five more to health watchdogs by the inquiry.

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