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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2016

01-12-2016 | Breast Oncology

Surgeon Volume, Patient Age, and Tumor-Related Factors Influence the Need for Re-Excision After Breast-Conserving Surgery

Authors: L. Hughes, BSc, J. Hamm, MSc, C. McGahan, MSc, C. Baliski, MD

Published in: Annals of Surgical Oncology | Special Issue 5/2016

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Abstract

Background

Breast-conserving surgery (BCS) is the preferred surgical approach for the majority of patients with early-stage breast cancer. There are frequent issues regarding pathologic margin status, requiring margin re-excision, and, in the literature, there is significant variability in re-excision rates, suggesting this is a potential quality-of-care issue. Understanding the patient-, disease-, and physician-related factors influencing reoperation rates is of importance in an effort to minimize this occurrence.

Methods

A retrospective analysis of all patients referred to our cancer center over a 3-year period (1 January 2011–31 December 2013) was performed. Surgeon volume, and patient- and tumor-related factors were assessed for their impact on re-excision rates. Multivariate logistic regression analysis was performed to identify variables of significance influencing reoperation rates after attempted BCS.

Results

Overall, 594 patients underwent initial BCS, with 159 (26.8%) patients requiring at least one re-excision to ensure negative pathologic margins. On multivariate analysis, low surgeon case volume, patient age (under 46 years of age), tumor size (>2 cm), and lobular carcinoma were associated with an increased re-excision rate.

Conclusion

Re-excisions are frequent after BCS and are influenced by surgeon volume, patient age, and tumor-related factors. These factors should be considered when counseling patients considering BCS, and also for quality assurance.
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Metadata
Title
Surgeon Volume, Patient Age, and Tumor-Related Factors Influence the Need for Re-Excision After Breast-Conserving Surgery
Authors
L. Hughes, BSc
J. Hamm, MSc
C. McGahan, MSc
C. Baliski, MD
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 5/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5602-8

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