Breast CA Surgery by High-Volume Surgeon's Show Significantly Lower Re-Op Rates
HealthDay News — The 90-day rate of reoperation following breast conservation surgery (BCS) for early-stage breast cancer has decreased overall and varies widely by surgeon, according to research published online February 17 in JAMA Surgery.
Abby J. Isaacs, of Cornell Medical College in New York City, and colleagues analyzed data for the period 2003 to 2013, from a New York State mandatory reporting database, for a population-based sample of 89,448 women undergoing primary BCS for cancer. Rates of reoperation within 90 days of the initial BCS procedure and factors affecting reoperation were assessed.
The researchers found that the overall rate of 90-day reoperation averaged 30.9% and decreased over time from 39.5% in 2003-2004 to 23.1% in 2011-2013. Rates of reoperation were highest in women aged 20 to 49 years (37.7%) and lowest in women aged 65 years or older (26.3%) (P < 0.001 for trend). Rates of reoperation varied widely by surgeon, from 0 to 100%. Unadjusted rates of reoperation were 35.2% for low-volume surgeons (<14 cases per year), 29.6% for middle-volume surgeons (14 to 33 cases per year), and 27.5% for high-volume surgeons (≥34 cases per year).
"Nearly one in four women underwent a reoperation within 90 days of BCS across New York State from 2011 to 2013, compared with two in five from 2003 to 2004," the authors write. "Rates vary significantly by surgeon, and initial BCS performed by high-volume surgeons was associated with a 33% lower risk for a reoperation."