Removing more tissue during a partial mastectomy could spare thousands of women with breast cancer the pain and worry of a second surgery.
Nearly 300,000 women in the United States are diagnosed with breast cancer each year and more than half of them undergo breast-conserving surgery with a partial mastectomy to remove the disease.
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 that often leads to a second surgery to ensure that no cancer remains.
A new study, published online in the New England Journal of Medicine, explored how removing more tissue all the way around the tumor site during the initial surgery—known as cavity shave margins (CSM)—could reduce the need for a second surgery.
For the study, 235 patients with breast cancer ranging from stage 0 to stage III, had a partial mastectomy as they normally would and were then randomized in the operating room to either have additional CSM removed or not.
“Despite their best efforts, surgeons could not predict where the cancer was close to the edge,” says lead author Anees Chagpar, associate professor of surgery (oncology) at Yale School of Medicine and director of The Breast Center at Smilow Cancer Hospital at Yale-New Haven.
“Taking cavity shave margins cut the positive margin rate in half, without compromising cosmetic outcome or increasing complication rates.”
Patients in the study will be followed for five years to evaluate the impact of the technique on recurrence rates.
“This randomized controlled trial has the potential to have a huge impact for breast cancer patients,” Chagpar says. “No one likes going back to the operating room, especially not the patients who face the emotional burden of another surgery.”
Patients in the study were enrolled at Smilow Cancer Hospital at Yale-New Haven. Researchers presented the findings at the 2015 Annual Meeting of the American Society of Clinical Oncology in Chicago.
Source: Yale University