Removing Additional Tissue During Mastectomy Could Reduce Chance of Second Surgery

More than half of women diagnosed with breast cancer undergo breast-conserving surgery with a partial mastectomy. A new study from the Yale Cancer Center found that removing more tissue during this procedure could spare thousands of these patients from a second surgery.

Somewhere between 20% and 40% of patients undergoing the procedure have cancer cells at the edge of what was removed, and the presence of these cells, or “positive margins,” often leads to a second surgery.

The researchers studied 235 patients with breast ranging from stage 0 to stage 3 with surgeons performing a partial mastectomy as usual. Patients were randomized in the operating room to either have additional tissue removed around the tumor site or not.

“Despite their best efforts, surgeons could not predict where the cancer was close to the edge,” the study’s lead author, Anees Chagpar, MD, MSc, MA, MPH, MBA, FRCS(C), FACS, associate professor of surgery (oncology) at Yale School of Medicine and director of The Breast Center at Smilow Cancer Hospital at Yale-New Haven, said in a statement. “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 5 years to evaluate the impact of the technique on recurrence rates.