Breast Cancer: Follow-Up Surgeries Common After Breast-Conserving Procedure

Nearly one in four women with breast cancer who undergo breast-conserving surgery are subjected to a second procedure to remove more tissue, despite the fact that some second surgeries may be unnecessary, according to a new study.

Researchers also found the rate of follow-up surgery varied widely from surgeon to surgeon.

WebMD reports that 3 out of 4 women with breast cancer choose to undergo breast-conserving surgery, in which surgeons remove only the cancerous cells and a few healthy ones nearby. Doctors opt for a follow-up procedure when they suspect that some cancerous cells have been left behind.

The study, published Tuesday in the Journal of the American Medical Association, probed follow-up surgery—or re-excision—rates at four research sites in the United States. 2,026 breast cancer patients initially undergoing breast-conserving surgery were included in the data.

23 percent of the patients included in the study underwent re-excision, after their doctors decided from post-operative reports that some cancerous cells were left behind in the first operation. Between eight and nine percent of the study cases ended up having a total mastectomy.

In addition, re-excision rates ranged up to 70 percent between surgeons, the researchers said.

Study author Laurence McCahill, MD, who is medical director of surgical oncology at the Lacks Cancer Center and a professor of surgery at Michigan State University, said the findings are troubling. In the cases of surgeons with high re-excision rates, a second surgery may be unnecessary, and surgeons with zero percent re-excision rates may be removing too much tissue in the first procedure or leaving cancerous tissue behind. “This study establishes that we have quite a bit of variation in how we deliver care to women who have partial mastectomies,” he said, as quoted by WebMD. “This issue has not really been part of the conversation between women and their surgeons, but it needs to be,” he says. “I think people will be surprised to find that almost a quarter of women who have partial mastectomies are going back for more surgery.”
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