Thousands of breast cancer patients could be spared a second operation if surgeons removed more tissue around the tumor site during surgery.
Removing an extra millimeter or two of surrounding tissue during breast cancer surgery can reduce the chance for follow-up surgery by half, according to a team of Yale researchers. More than 230,000 women are diagnosed with breast cancer each year in the United States. In most cases, majority of the women undergo surgery to remove the tumor rather than the entire breast. However, between 20 percent and 40 percent of patients who undergo this procedure have "positive margins", or cancer cells found at the edge of what is removed.
The presence of positive margins often leads to a second surgery to remove the cancer remains.
The researchers explored how removing more tissue around the tumor site during initial surgery known as cavity shave margins (CSM) could reduce the need for a second surgery. The study tested cavity shaving, 235 patients with breast cancer were given usual breast cancer surgery. Patients were then randomized in the operating room to get the extra cavity shave.
"With a very simple technique of taking a little more tissue at the first operation we can reduce the chances that somebody would need to go back to the operating room a second time by 50 percent. When you think about the emotional impact, let alone the economic impact, of those second surgeries, that’s a big deal," said the study leader, Yale Cancer Center’s Dr. Anees Chagpar.
Only 10 percent of women who had extra tissue removed needed a second surgery versus 21 percent of the others.
Chagpar said the results of the study are strong enough that many surgeons may adopt the new technique.
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