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Warning over partial breast cancer ops

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Women undergoing treatment for breast cancer should be warned that 20% of patients who chose to only have part of the breast removed are likely to need a second operation, scientist said.

Researchers made the suggestion after they found that one in five English women who underwent breast conserving surgery needed further treatment.

There are 45,000 women diagnosed with breast cancer each year in England. Of these, 58% chose to have part of the breast removed - breast conserving surgery - rather than a mastectomy which sees the whole breast removed.

When combined with radiotherapy, breast conserving surgery produces similar survival rates to those achieved with mastectomy alone.

But because some tumours are difficult to detect, breast conserving surgery may result in their inadequate removal and lead to another operation.

The study, published in the British Medical Journal, examined the reoperation rates of 55,297 women who had primary breast conserving surgery in 156 NHS trusts in England between April 2005 and March 2008.

Of these women, 11,032 needed a second operation within three months.

Among women who had breast conserving surgery as a reoperation, one in seven needed further surgery, researchers found.

More than 80% of the the 55,000 women were suffering from isolated invasive cancer, 12% had isolated carcinoma in-situ - or pre-cancerous disease - and 6% had both invasive and in-situ disease.

Reoperation was more likely among women with pre-cancerous disease compared to those with isolated invasive disease.

Around 40% of women who had a reoperation underwent a mastectomy.

Reoperation rates also varied between NHS trusts - in some Trusts reoperation rates were below 10% while in others they were above 30% - but the authors stress that further research is required to understand its cause.

“Cosmetic outcomes after surgery for breast cancer are an important consideration, and women should be made aware of the local rates of reoperation after primary breast conserving surgery, along with the likelihood of proceeding to mastectomy,” the authors wrote.

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Readers' comments (2)

  • I was diagnosed with breast cancer in July 2009 following a routine mammogram. I had a wide incision lumpectomy for a 11mm lump. Unfortunately I had another lumpectomy 2 weeks later as the surrounding area had some invasive tissue surrounding the original lump. I had lymph nodes excised at the original operation which showed no spread. This was followed by 16 radiotherapy sessions. I am now in remission. I do have yearly mammograms and I feel lucky to have had breast conservation surgery. It may not be ideal, but I still have both breasts, albeit one smaller that the other.

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  • I have worked with women with breast cancer for twenty years this is nothing new. We always discuss the possibility of further sugery because of incomplete excision especially if DCIS found.

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