An Evaluation of Rates of Breast Re-Excision in Patients Undergoing Breast Conserving Surgery with Adjuvant Radiotherapy for Breast Cancer

Abstract

Background: Most women diagnosed with early stage breast cancer have the option of receiving either mastectomy or breast conserving surgery (BCS) plus adjuvant radiotherapy as randomized clinical trials have reported equivalent outcomes in terms of mortality. BCS followed by radiotherapy is generally the preferred treatment option for early stage breast cancer as BCS is less invasive, associated with less morbidity and a superior cosmetic outcome than mastectomy. Primary disadvantages of this treatment include the risk of positive resection margins that necessitate additional surgery by either further BCS or mastectomy. Re-excision is associated with greater morbidity, patient anxiety, inferior cosmetic outcome, delayed initiation of adjuvant therapies, and increased medical cost. Our aim was to evaluate re-excisions rates at our hospital and assess the impact of gaining a radiologist opinion on the specimen x-ray makes on re-excision rates. Furthermore, we aimed to confirm that all breast conservation procedures including non-image guided WLE’s (palpable lesions) need specimen x-rays.