One in five women who undergo breast-conserving surgery for cancer instead of a mastectomy require a second operation within three months, British researchers reported this week. The survival rates for breast-conserving surgery combined with radiation and for mastectomy are about the same, but the need for a second operation can introduce extra anxiety for the patient, as well as additional cost. The need for a reoperation was most common for women with ductal carcinoma in situ, a form of cancer whose edges are very difficult to define for removal of the tumor.
An estimated 45,000 women in England are diagnosed with breast cancer each year, and 58% of them have breast-conserving surgery, which makes cosmetic repair of the body easier. In the United States, about 450,000 women are diagnosed with the disease each year.
A team headed by Dr. David A. Cromwell of the London School of Hygiene & Tropical Medicine studied the records of 55,297 women who underwent breast-conserving surgery between April 1, 2005, and March 31, 2008. They reported this week in BMJ, formerly known as the British Medical Journal, that 11,032 (20%) had at least one reoperation. Among women with isolated invasive disease, 18% had a reoperation, but among those with ductal carcinoma in situ, 29.5% had a reoperation. The actual rates of reoperation varied somewhat with the region of the country.