Partial mastectomy often followed by second surgery

[xchrom]

http://www.latimes.com/health/boostershots/la-heb-partial-mastectomy-20120131,0,2836622.story

A partial mastectomy allows doctors to remove a cancerous tumor without having to remove the entire breast. However, a new study shows that 1 in 4 women who undergo a partial mastectomy have to return for another surgery to remove additional tissue (called a reexcision).

The study points to a long-standing problem in breast cancer treatment: There is no agreement among surgeons on how much healthy surrounding tissue to take out when removing a tumor. Surgeons don't want to take out more tissue than is necessary, because they wish to spare the breast. However, if cancer cells are left behind, the disease could spread. Up to 75% of breast cancer patients have a partial mastectomy.

In the new study, researchers looked at breast tumor excisions from 2,206 women. Among them, 22.9% underwent at least one additional surgery to remove more tissue. The study showed that surgeons differed on what they considered to be a "clear margin," free of cancer.

More effort should be made to better define "the appropriate distance required for a clear margin to be deemed adequate," the authors said. Patients don't wish for a return of their cancer, but being called back for follow-up surgeries takes a toll, too.

"Despite the significant physical, psychological and financial effect of partial mastectomy reexcisions on patients, there remains a lack of standardization regarding its application among surgeons performing breast cancer surgery," the authors wrote.

[Roselma]

1. That is why my sister-in-law opted for a total mastectomy

when stage II cells were found in tumors in both her breasts. The doctors wanted to do a lumpectomy on each breast, followed by chemo, followed by radiation. Instead, she told the doctors that her breasts meant little to her now that she is in her 60's. She wanted them gone since she developed tumors in both breasts in a one-year period. They did agree to do the double total mastectomy but offered to do immediate reconstruction surgery. She said no. She decided to wear a nice prosthetic instead. When asked why no reconstruction, she pointed out the troubles her friends had with continued lymphedema with their reconstructed breasts. She made a good call. Two and a half years later, no recurrence, no pain after the first month, recovered from minor lymphedema, and looks good in bathing suits and sweaters with the prosthetic breasts.