Science Current Events | Science News | Brightsurf.com
 

Fewer women need repeat breast cancer surgeries with new service at University of Michigan

February 29, 2012

ANN ARBOR, Mich. -- Nearly one in three women who have breast cancer surgery will need to return to the operating room for additional surgery after the tumor is evaluated by a pathologist.

A new service at the University of Michigan Comprehensive Cancer Center cuts that number drastically by having pathologists on-site in the operating suite to assess tumors and lymph nodes immediately after they are removed. Meanwhile, the surgeon and patient remain in the operating room until the results are back, and any additional operating can be done immediately.

This cut the number of second surgeries needed by 64 percent, to one of every 10 women.

U-M began offering the service about two years ago at its East Ann Arbor Ambulatory Surgery Center, where the majority of outpatient breast cancer surgeries now occur. A study evaluating 271 patients treated eight months before and 278 treated eight months after this program began appears in the American Journal of Surgery.

"The frequent need for second surgeries among patients undergoing breast cancer surgery represents a tremendous burden for patients. Beyond the inconvenience and additional time away from work, additional surgeries can result in worse cosmetic outcomes and increased complication rates. Our experience shows that offering on-site pathology consultation has a substantial impact on quality of care," says lead study author Michael S. Sabel, M.D., associate professor of surgery at the U-M Medical School.

Patients must return to the operating room for two primary reasons: to remove additional tissue when the cancer cells are too close to the margin of tissue removed; and in some cases, to remove additional lymph nodes if the initial sentinel lymph node biopsy tests positive for cancer.

Before the on-site pathology, 25 percent of patients needed a second operation to remove more tissue, compared to 11 percent after the service began. Among patients with cancerous lymph nodes, 93 percent of them avoided a second surgery with on-site pathology.

In addition to reducing second surgeries, the study found that assessing the margins in the OR allowed more women to conserve their breasts. The study authors suggest that women who have positive margins requiring additional surgery are more likely to choose mastectomy because they fear their cancer will return or that they'll need a third operation.

Establishing on-site pathology requires a different technique for preserving and evaluating the cells, called frozen section analysis. After this is completed, U-M pathologists then process the tumors for standard testing using traditional methods. The study showed consistent results across both types of analysis.

On-site pathology using frozen tissue sections is offered at a handful of academic medical centers across the country.

"In large part, routine intraoperative analysis of lumpectomy margins is rare because of logistical issues, especially as breast surgery is more commonly performed at outpatient surgical centers," Sabel says.

Obstacles include transporting the tissue samples, building a pathology facility, and staffing it appropriately at an offsite surgical center.

"Despite these obstacles, we found that not only is this beneficial for our patients, but it reduced the costs of caring for patients with breast cancer," Sabel adds.

The study authors also considered new guidelines that suggest fewer women need to have their lymph nodes removed if the sentinel lymph node biopsy is positive. The authors factored in that reduction and still found that intraoperative analysis was highly cost-effective.

"Establishing an intraoperative pathology consultation service is feasible, highly efficient and extremely beneficial to patients, surgeons and reducing the costs of cancer care," Sabel says.

University of Michigan Health System


Related Breast Cancer Surgeries Current Events and Breast Cancer Surgeries News Articles


African American Women Receive Less Breast Reconstruction after Mastectomy
Dartmouth researchers have found that African American women are 55 percent less likely to receive breast reconstruction after mastectomy regardless of where they received their care.

Needle biopsy underused in breast cancer diagnosis, negatively impacting diagnosis and care
Needle biopsy, the standard of care radiological procedure for diagnosing breast cancer, is underused with too many patients undergoing the more invasive, excisional biopsy to detect their disease, according to research from The University of Texas MD Anderson Cancer Center.

Presurgical SPECT/CT Shows More Cancer Than Current Standard
Startling data from an international multi-center trial provide growing evidence that sentinel node imaging is more effectively accomplished with hybrid functional imaging with single photon emission computed tomography and computed tomography (SPECT/CT) than with another molecular imaging technique called lymphoscintigraphy.

New possibilities for breast cancer treatment on the horizon
he first patient scans from a custom-built scanner combining positron emission tomography (PET) and computed tomography (CT) technologies indicate that these scans could significantly improve breast cancer imaging capabilities and lead to more targeted treatment options, according to researchers at SNM's 55th Annual Meeting.
More Breast Cancer Surgeries Current Events and Breast Cancer Surgeries News Articles

Breast Cancer Surgery and Reconstruction: What's Right For You

Breast Cancer Surgery and Reconstruction: What's Right For You
by Patricia Anstett (Author), Kathleen Galligan (Photographer)


More than 100,000 American women undergo mastectomy and breast reconstruction every year because of breast cancer. Thousands more are having double mastectomies to prevent it. So much has been written about breast cancer, and so much overlooks the reality of reconstruction when a woman has a mastectomy and opts for this process. It is difficult, painful, and traumatizing at times. Most women do not emerge with a new set of breasts and nipples in a single operation. Breast reconstruction usually takes months and can take years to finish. Some women never do, living without nipples or with imperfect results. Others opt not to have reconstruction at all. Still others struggle with one of the biggest women’s health questions today: lumpectomy and radiation or mastectomy?

Breast...

Breast Cancer Clear & Simple, Second edition: All Your Questions Answered (Clear & Simple: All Your Questions Answered series)

Breast Cancer Clear & Simple, Second edition: All Your Questions Answered (Clear & Simple: All Your Questions Answered series)
by American Cancer Society (Author)


A breast cancer resource for the newly diagnosed from the experts at the American Cancer Society
 
With an easy-to-understand, question-and-answer format, this book guides patients through the important decisions they’ll need to make, from diagnosis through treatment. It helps women with breast cancer and their caregivers know what to expect, what to do, and how to get through what can be an overwhelming, life-changing experience. This new edition includes tips for choosing the right doctor, understanding treatment choices, dealing with the effects of treatment, seeking support groups, and much more. A list of specific resources for patients, as well as a glossary of terms related to breast cancer, is also included.

The Breast Cancer Survival Manual, Fifth Edition: A Step-by-Step Guide for Women with Newly Diagnosed Breast Cancer

The Breast Cancer Survival Manual, Fifth Edition: A Step-by-Step Guide for Women with Newly Diagnosed Breast Cancer
by John Link (Author)


The updated edition of the essential resource for the 250,000 women diagnosed with breast cancer each yearBreast cancer is the leading cause of death in women from thirty-five to fifty-four years of age, and few things are as terrifying and confusing as a diagnosis of this disease. The fifth edition of The Breast Cancer Survival Manual is a concise, information-packed guide that is newly revised to contain all of the latest findings to help the woman facing treatment feel informed and empowered. John Link, M.D., a pioneer developer of Breastlink Medical Group in Southern California includes the most current medical advice on • Tamoxifen, Herceptin, and other chemotherapy options • The growing importance of HER2 oncogene testing • Clinical research trials under way that...

Living Through Surviving (A Woman's story of Breast Cancer, Courage, and Intimacy after a Mastectomy, First Edition)

Living Through Surviving (A Woman's story of Breast Cancer, Courage, and Intimacy after a Mastectomy, First Edition)
by Suzy Crownover (Author), A breast cancer diagnosis changes the way you feel about your body for the rest of your life. (Introduction)


Living Through Surviving is a personal journey through breast cancer. Any patient that has had a mastectomy or is going to have, this is a must read. Suzy vividly describes how she came to terms with these life changing decisions.

Breast Cancer: Fundamentals of Evidence-Based Disease Management

Breast Cancer: Fundamentals of Evidence-Based Disease Management
by I. Craig Henderson (Author)


Breast Cancer provides an in-depth understanding of the biology of breast cancer, the natural history of the disease, the use of molecular markers, the interpretation of clinical trial data, and the integration of multiple therapeutic modalities. The single most important fact about breast cancer is the great variation in its natural history and its responsiveness to therapy from one patient to another. The clinician must integrate an assessment of the patient's likely course based on clinical and pathological staging and laboratory studies with objective evidence on the benefits of therapy. The primary aim of this book is to provide the clinician with the tools to do just that. Outcomes of clinical trials and details about commonly used drug regimens, drug dosage, and the expected side...

The Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery, 3rd Edition

The Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery, 3rd Edition
by Kathy Steligo (Author)


For a decade The Breast Reconstruction Guidebook has been the best resource on this topic for women who have had a mastectomy. Equal parts science and support, it is filled with stories that illustrate the emotional and physical components of breast reconstruction. Readers will find advice about choosing a doctor and a procedure, insurance and payment issues, how to prepare for surgery, and what to expect during recovery.Expert commentary by physicians and insights from patients inform this book, as does the exhaustive research by the author, a two-time breast cancer survivor who has twice had reconstructive surgery. New in this edition are discussions of• the pros and cons of saline and silicone implants • solutions for post-lumpectomy cosmetic problems• new immediate-delayed...

Breast Cancer (MD Anderson Cancer Care Series)

Breast Cancer (MD Anderson Cancer Care Series)
by Kelly K. Hunt (Editor), Geoffrey L. Robb (Editor), Eric A. Strom (Editor), Naoto T. Ueno (Editor), J. Mendelsohn (Editor)


Now in this, its second edition, this fully revised clinical guidebook is an essential resource for the practitioner, allowing quick, authoritative access to the latest and best in multimodality therapies. Topics covered in this volume include everything from screening for early detection of breast cancer, through diagnostic radiology and ultrasonography, to post-treatment rehabilitation, symptom management and quality of life. Two new chapters on molecular prognostic and predictive markers, and sexuality and fertility issues in women with breast cancer, have been added. This is the 7th volume in the M.D. Anderson Cancer Care Series, featuring the best standard treatment protocols from the experts at M.D. Anderson Cancer Center.

Forever Changed (The Forever Series Book 1)

Forever Changed (The Forever Series Book 1)


There’s nothing like finding out you have breast cancer to make you take a second look at your life. Along with the diagnosis, Ariana finds a new reason to live when she meets tattoo artist Blaine Bennett. But Blaine’s reaction when she informs him of the pending double mastectomy isn’t what she expected. Can two people who so obviously belong together deal with the outside forces keeping them apart?
Each book in the ‘Forever’ series focuses on a woman at a crossroads in her life. These romances contain no graphic sex, but instead focus on the woman’s story, and how her journey leads to love. Novella-length at between 32,00-40,000 words, they are complete stories, and may be read in any order. Enjoy!


Chicken Soup for the Breast Cancer Survivor's Soul: Stories to Inspire, Support and Heal (Chicken Soup for the Soul)

Chicken Soup for the Breast Cancer Survivor's Soul: Stories to Inspire, Support and Heal (Chicken Soup for the Soul)
by Jack Canfield (Author), Mark Victor Hansen (Author), Mary Olsen Kelly (Author)


Along with the shock, fear and loss many women face upon a breast cancer diagnosis comes unexpected strength, wisdom, and strong networks of sharing, support and healing. In Chicken Soup for the Breast Cancer Survivor's Soul, survivors and their family members talk openly about how difficult their fight with breast cancer has been and how they made it through the dark times with a belief in a higher power and the support of those closest to them.

Big C, little ta-ta: Kicking Breast Cancer's Butt in 7 Humorous Stories

Big C, little ta-ta: Kicking Breast Cancer's Butt in 7 Humorous Stories
by Janet Sheppard Kelleher (Author)


Big C, little ta-ta: Kicking Breast Cancer's Butt in 7 Humorous Stories From leaky prosthetics and DIY tattoos to chemotherapy, wigs, boobs, and biopsies, Janet Sheppard Kelleher takes readers on a zany journey through her breast cancer experience. A victor since 2000, Jan finds the "funny" in the most unlikely places. Join her in kicking breast cancer’s butt with humor and hope. This gift book is the first in a series designed to give hope, inspiration, and optimism to others like Jan on their breast cancer journey. It’s the perfect elixir for the newly diagnosed, the survivor, and the caregiver - a dose of sunshine. Big C, little ta-ta provides a bright spot during a time that is no laughing matter. What a gift - at the cost of a quality greeting card! Visit Jan's Facebook page...

© 2016 BrightSurf.com