Greater Breast Tissue Removal Could Cut Chance of Second Surgery
(HealthDay News) — Thousands of breast cancer patients in the United States might be spared a second surgery if more tissue was removed during initial breast-conserving, partial mastectomy surgery, a new study suggests. The study was published online May 30 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Society of Clinical Oncology, held from May 29 to June 2 in Chicago.
The study was led by Anees Chagpar, MD, MPH, an associate professor of surgery at the Yale School of Medicine in New Haven, CT, and included 235 patients with stage 0 to III breast cancer who underwent standard partial mastectomy. All of the women were then randomly selected in the operating room to have further cavity shave margins resected or not to have further cavity shave margins resected.
The researchers found that cavity shaving halved the rates of positive margins and reexcision. "Despite their best efforts, surgeons could not predict where the cancer was close to the edge," Chagpar noted in a Yale news release. Removal of cavity shave margins was deemed effective "without compromising cosmetic outcome or increasing complication rates," according to Chagpar, who also directs The Breast Center at Smilow Cancer Hospital at Yale-New Haven.
Her team said it will track outcomes for the patients for five years to assess how the removal of extra tissue affects the risk of a cancer recurrence. "This randomized controlled trial has the potential to have a huge impact for breast cancer patients," Chagpar said. "No one likes going back to the operating room, especially not the patients who face the emotional burden of another surgery."