Additional Surgery After Initial Lumpectomy
The results of a population-based cohort survey study of more than 3700 women between the ages of 20 and 79 with early-stage breast cancer reveal that additional surgery after initial lumpectomy decreased markedly between 2013 and 2015. Monica Morrow, MD, of the Memorial Sloan Kettering Cancer Center in New York, and colleagues attribute this changing trend to the dissemination of clinical guidelines endorsing a minimal negative margin based on a 2014 consensus statement. The full study details are reported in a recent issue of JAMA Oncology.
The 3729 women who took part in the survey were identified from the Georgia and Los Angeles County, California, Surveillance, Epidemiology, and End Results registries. Those with bilateral disease and ductal carcinoma were not included in this analysis.
Between 2013 and 2015, reexcision and conversion to mastectomy declined substantially among patients with negative surgical margins. During this period, the rate of breast-conserving surgery (final lumpectomy) increased by 13%, from 52% to 65%, with a decrease in both unilateral and bilateral mastectomies.
Dr. Morrow and colleagues conclude that these surgical trend findings indicate “surgeon-led initiatives to address potential overtreatment can reduce the burden of surgical management in patients with cancer.”