New guideline decreases breast cancer re-operation rates

April 09, 2019

A UBC medical student has determined that a new surgical guideline is making a difference for breast cancer patients.

Alex Monaghan, a second-year Southern Medical Program (SMP) student at UBC Okanagan, recently completed a study using patient data from BC Cancer-Kelowna. His research compared re-operation rates for breast cancer patients before and after a new surgical guideline was introduced five years ago.

Breast-conserving surgery (BCS) and radiation therapy is a common first step in treating early-stage breast cancer. Following BCS, the removed portion of a woman's breast is inked with permanent dye to allow doctors to measure the amount of healthy tissue surrounding a tumour and to determine whether the surgery was adequate.

Historically, debate has centred on the desired amount or margin of space between the tumour and inked edges to optimize patient outcome. With a lack of consensus, re-operation rates as reported by North America public-health institutions have varied considerably between 17 to 35 per cent.

In 2014, the Society of Surgical Oncology and American Society for Radiation Oncology released the new guideline of 'no tumour on ink' for cancer patients undergoing BCS.

"The guideline states that if a tumour does not touch the inked portion of tissue, re-operation may not be warranted," says Monaghan lead author of the study. "Further surgery can lead to increased risk of medical complications and worsened cosmetic effects, without any evidence of prolonged survival or decreased cancer recurrence."

Monaghan compared data of more than 1,100 patients from 2011 to 2017 to measure re-operation rates before and after the guidelines came into practice. As the primary referral centre for Interior Health, BC Cancer-Kelowna services 10 regional hospitals across the BC Interior. He conducted his research under the guidance of Dr. Christopher Baliski, a surgical oncologist at Kelowna General Hospital and BC Cancer, as well as an SMP clinical assistant professor.

Based on his findings, Monaghan found that a woman with early-stage breast cancer is 72 per cent less likely to have a re-operation after a lumpectomy today compared to 2014 and earlier.

"The research shows how the guideline has been adopted by community surgeons across the BC Interior," says Monaghan. "Patients can avoid potential surgical complications, added stress, and the cosmetic effects are minimized. In addition, healthcare costs are reduced as a whole."

Monaghan presented his work at the 105th meeting of the North Pacific Surgical Association in November of 2018. The study, supported by BC Cancer's Surgical Oncology Network, was published recently in the American Journal of Surgery.
-end-


University of British Columbia Okanagan campus

Related Surgery Articles from Brightsurf:

Decision conflict before cancer surgery correlates with lower activity after surgery
Nearly one-third of cancer patients who decide to undergo surgery for their condition may have second thoughts, and this decision conflict may lead to less favorable treatment outcomes in both the near- and long-term, according to a team of investigators at Massachusetts General Hospital and Ariadne Labs.

Examining association between weight loss before bariatric surgery, risk of death after surgery
Researchers looked at whether a patient's body weight and weight loss before bariatric surgery were associated with risk of death within 30 days after surgery using data from nearly 500,000 patients in the US and Canada.

Guidelines for thyroid surgery published in Annals of Surgery
The first set of comprehensive, evidence-based clinical guidelines for surgical treatment of thyroid disease -- developed by an expert panel assembled by the American Association of Endocrine Surgeons (AAES) -- was published today by Annals of Surgery.

Colorectal surgery patients use fewer opioids, report less pain with enhanced recovery after surgery
Colorectal surgery patients who were a part of an enhanced recovery after surgery (ERAS) program had less pain, while using nearly half as many opioids, according to research being presented at the ANESTHESIOLOGY® 2019 annual meeting.

Video assisted lung surgery reduces complications and hospital stays compared to open surgery
Video-assisted thoracic surgery is associated with lower in-hospital complications and shorter length of stay compared with open surgery among British patients who were diagnosed at an early stage of lung cancer, according to research presented today the IASLC 2019 World Conference on Lung Cancer, hosted by the International Association for the Study of Lung Cancer.

Most deaths related to noncardiac surgery occur after surgery and after discharge from hospital
It's not the operating room that is risky for patients undergoing noncardiac surgery; it's the recovery period.

Study looks at opioid use after knee surgery
A small study looked at whether reducing the number of opioid tablets prescribed after knee surgery would reduce postoperative use and if preoperative opioid-use education would reduce it even more.

Surgery patients are getting older every year
A new BJS (British Journal of Surgery) analysis reveals that people undergoing surgery in England are getting older at a faster rate than the general population.

Children requiring thyroid surgery have better outcomes at high-volume surgery centers
New research recently published in the Journal of Pediatric Surgery found that post-operative success rates of pediatric thyroid patients, particularly children who require a thyroidectomy, correlate with the institution's patient volume.

Do negative public attitudes toward weight loss surgery stop some patients from having surgery?
Most patients who qualify for weight loss surgery don't have the procedure despite its safety and effectiveness.

Read More: Surgery News and Surgery Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.