New research indicates that breast cancer surgery may need to be repeated less often as additional tissue is removed during partial mastectomies. This finding could help women avoid potentially dangerous, costly surgeries.
A partial mastectomy is a procedure that helps women battle breast cancer and to reduce their risk from the disease. The operation involves the removal of as much breast tissue as possible, while still leaving the nipple in place.
A new study shows that between 20 and 40 percent of patients undergoing this procedure are left with cancer cells in a "positive margin" of tissue, just beyond the amputated region. Even a total mastectomy – which involves the removal of both breasts – can't purge breast cancer entirely from the body.
Yale Cancer Center researchers examined 235 breast cancer patients at different stages of the disease, from stage zero to stage three. All patients received surgery, and some were randomly selected to have additional tissue – cavity shave margins (CSM) – removed.
Of those provided with standard surgery, 21 percent required a second operation, as opposed to the 10 percent of patients who underwent CSM.
"Despite their best efforts, surgeons could not predict where the cancer was close to the edge. Taking cavity shave margins cut the positive margin rate in half, without compromising cosmetic outcome or increasing complication rates," said Anees Chagpar from the Yale School of Medicine and The Breast Center at Smilow Cancer Hospital.
Almost 300,000 American women are diagnosed with breast cancer each year, and over 40,000 will die of of the disease, according to statistics from the American Cancer Society. More than half of these patients elect to undergo partial mastectomies in order to reduce their future risk of the disease.
Patients in this study were examined at the Smilow Cancer Hospital at Yale-New Haven in Connecticut. There was no difference in the frequency of complications between the two groups in the study. The subjects will be followed for five years to measure the impact of CSM on those who underwent each form of surgery.
"This randomized controlled trial has the potential to have a huge impact for breast cancer patients. No one likes going back to the operating room, especially not the patients who face the emotional burden of another surgery," Chagpar said.
Results of the study were presented at the 2015 Annual Meeting of the American Society of Clinical Oncology, held in Chicago from May 29 to June 2, 2015.
Analysis of the effect of cavity shave margins in reducing the risk of repeated breast cancer surgery was detailed in the New England Journal of Medicine.
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