60 Chapter 4 However, RRs were low. Although the surveys were compact and sent multiple times, the RR remained 10-15%, compared to substantial higher rates of 53% in other doctor surveys.15 This could be explained by the fact that not all plastic surgeons are specialized in breast surgery, so plastic surgeons with less interest in this topic were probably less likely to participate. Also, there could be some selection bias, as breast surgeons and plastic surgeons with a special interest in this subject were more tending to respond. This study reported a preliminary overview of the Dutch practice and opinions regarding preservation of the PF. Yet, the results are interesting and important to draw more attention to this topic. The planned follow-up study should focus on increasing response rates by contacting the surgery and plastic surgery departments in all Dutch hospitals directly for the distribution of the surveys and additional questions should be added. In conclusion, preservation of the PF does occur in a substantial part of the Dutch medical centers, and techniques widely differ between medical centers. Future studies on this topic should clarify the effect of PF preservation on oncological safety, complication rates, postoperative pain, cosmetic outcomes and patient satisfaction.
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