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    1 in 4 Breast Lumpectomies Requires More Surgery

    Risk after breast-conserving operation is lower with 'high-volume' surgeons, researchers say

    WebMD News from HealthDay

    By Kathleen Doheny

    HealthDay Reporter

    WEDNESDAY, Feb. 17, 2016 (HealthDay News) -- Women with early stage breast cancer who opt for a breast-conserving surgery known as a lumpectomy have a one in four chance they will need a second operation within 90 days, researchers report.

    "The chance of getting a second surgery has gone down a little, but it is still high and it is substantial," said study author Dr. Art Sedrakyan. He is a professor of health care policy and research at Weill Cornell Medicine in New York City.

    In a lumpectomy, the tumor tissue, along with a margin of surrounding tumor-free tissue, is removed. However, if the tissue in the margin is not completely free of tumor cells, a second operation is needed.

    During the study period, which ran from 2003 through 2013, the overall rate of re-operation within 90 days was almost 31 percent, Sedrakyan said. It declined from nearly 40 percent in 2003 through 2004, to 23 percent from 2011 through 2013, the study found.

    "Having a second surgery after you think you've solved all your problems is stressful," Sedrakyan said.

    The question of how often women need a repeat surgery is critical for a number of reasons, Sedrakyan explained. These reasons include letting women know the risk of re-operation if they choose breast-conservation surgery. Doctors also need to know the risk so they can come up with guidance to help reduce that risk, he said.

    "Patients operated on by higher-volume doctors had a lower chance of getting this re-operation," Sedrakyan said. High-volume surgeons were defined as those who had 34 or more cases a year, on average, while low-volume surgeons had 13 or fewer cases. The lowered risk with high-volume doctors was about 33 percent, the study findings showed.

    The study appears in the Feb. 17 online edition in the journal JAMA Surgery.

    The researchers evaluated data on nearly 90,000 women who had lumpectomies in hospitals and ambulatory surgery centers in New York. The rates of re-operation were highest among those aged 20 to 49 and lowest in those aged 65 and older.

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