Repeat Surgery After Breast Conservation for the Treatment of Stage 0 to II Breast Carcinoma

Abstract

Approximately one-fourth of all patients who undergo initial breast conservation surgery for breast cancer will have a subsequent operative intervention. The rate of repeat surgeries varies by patient, tumor, and facility factors and has decreased slightly during the past 6 years.

Assessment of the extent of microcalcifications to predict the size of a ductal carcinoma in situ: comparison between tomosynthesis and conventional mammography

“…However there are cases, where an extension of the resection or a re-excision might become necessary if positive margins remain [19]. Not fully resected DCIS could be on the basis of non-calcified areas, which are mentioned in the literature to be up to 40% 7 .…”

Reoperation Costs in Attempted Breast-Conserving Surgery: A Decision Analysis

“…Reoperation rates are highly variable [1][2][3][4][5] , and although there is no evidence that re-excision is detrimental to overall survival 23 , it likely causes patient anxiety, increases surgical complication rates 24 , and contributes to poorer cosmetic results 10,25 . It might also delay the initiation of adjuvant chemotherapy.…”

“…Given the significant variation in the need for reoperation after an initial attempt at bcs, the reoperation rate becomes a potential area of focus in the pursuit of health care cost reductions. A number of factors determine the need for reoperation, including disease 3,5,34-37 , patient-related considerations [3][4][5] , and potential influences of the surgeon 2,35,38,39 and the institution [3][4][5]8 . Although changing disease-and patient-related factors is difficult, there are structural and process-related measures that could potentially be implemented to reduce the need for reoperation.…”

“…Although bcs is an excellent alternative to mastectomy, one potential downside is the frequent need for reoperation to address concerns about the pathologic status of the surgical margins. The frequency of re-excision shows significant variability, with institutional reviews reporting reoperation rates in the range 0% -60% 1 , and population-based studies reporting 17%-35% [2][3][4][5] . A recent report based on data from the Canadian Institute for Health Information (cihi) suggested a mean reoperation rate of 23% in Canada 6 , with significant interprovincial variability.…”

Radioactive Seed Localization for Nonpalpable Breast Lesions in a Community Hospital Setting

“…The surgical margins are frequently positive, which then requires an additional surgical procedure to remove more breast tissue to obtain clear margins (Cody & Van Zee, 2015;McCahill et al, 2012). A recent report from the National Cancer Database including 316, 114 patients undergoing breast conserving surgery from 2004 through 2010, demonstrated roughly one-fourth of patients required a second procedure (Wilke et al, 2014).…”