In this series, 1 cm margins were associated with a small increase in LR that did not impact OS. This is concordant with the NCCN recommendations; however, a prospective, randomized trial would be optimal.

Introduction: Co-surgeon approach for bilateral mastectomy may lead to shorter operative times and improved outcomes compared with single-surgeon approach, but cost differences remain unclear. Economic models were applied to determine whether either approach offered a lower cost opportunity. Methods: A retrospective review of 409 patients undergoing single-surgeon or cosurgeon bilateral mastectomy between January 1, 2010 through April 30, 2016 was conducted. Outcomes included narcotic and antinausea doses, length of stay (LOS), and operative time. Analyses stratified by reconstruction and no reconstruction included Wilcoxon tests, Poisson regression, generalized linear models, and a cost calculator. Results: Of 409 patients, 310 had reconstruction and 99 had no reconstruction.Compared with single-surgeon approach, co-surgeon approach was associated with less operative time and shorter LOS (233 vs. 250 min and 1.0 vs. 1.8 days no reconstruction; and 429 vs. 493 min and 2.2 vs. 2.8 days reconstruction). Economic analysis demonstrated less operative time, shorter LOS, and lower average cost for co-surgeon approach

The cover image is based on the Research Article Single surgeon versus co‐surgeon bilateral mastectomy: Comparing outcomes and costs based on health economic modeling from the perspective of the hospital system by Laura Hudson MD et al., https://doi.org/10.1002/jso.26891