Our Summary

This research aimed to better understand recurrence and survival rates in patients who had a certain type of breast cancer surgery, where the surgeon removes additional layers of tissue around the tumor (called cavity shave margins or CSMs). They looked back at 10 years of data from their own hospital and found that out of 839 patients who had this procedure, about 8.5% needed to have more surgery to remove more of the cancer.

The type of cancer the patient had affected the likelihood of having cancer found at the edges of the tissue removed (positive margin). The presence of positive margins, either in the lumpectomy (tumor removal) or CSMs, was linked to higher chances of the cancer coming back.

However, when they looked at survival rates specifically related to breast cancer after five years, they didn’t see a significant difference between patients with different combinations of positive or negative margins.

In conclusion, taking additional tissue (CSMs) during surgery helps to identify patients who may have a higher risk of their cancer returning.

In simpler terms, this surgery where extra tissue is taken could help doctors figure out who might be at more risk of their breast cancer coming back. But whether or not cancer was found in that extra tissue didn’t seem to impact how likely patients were to survive their cancer after five years.

FAQs

  1. What is the purpose of removing additional layers of tissue (CSMs) during breast cancer surgery?
  2. Does the presence of cancer in the additional tissue (CSMs) impact the five-year survival rate for patients?
  3. How does the type of breast cancer affect the likelihood of finding cancer at the edges of the removed tissue?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumpectomy is to follow up closely with your healthcare team for regular screenings and monitoring. This can help catch any potential recurrence of cancer early and improve your chances of successful treatment. Additionally, maintaining a healthy lifestyle, including a balanced diet and regular exercise, can also support your overall health and recovery after surgery.

Suitable For

Patients who are typically recommended lumpectomy are those with early-stage breast cancer, where the tumor is small and localized. Lumpectomy is often recommended for patients with stage 0, stage 1, and some stage 2 breast cancers. It is also recommended for patients who have smaller tumors and who have not spread to the lymph nodes. Patients with larger tumors or more advanced stages of breast cancer may be recommended for a mastectomy instead of a lumpectomy. Ultimately, the decision on the type of surgery recommended will depend on the individual patient’s specific circumstances and preferences, and should be made in consultation with their healthcare team.

Timeline

Before lumpectomy:

  • Patient undergoes diagnostic tests such as mammogram, ultrasound, and biopsy to confirm the presence of breast cancer.
  • Patient meets with surgeon to discuss treatment options, including lumpectomy.
  • Patient may undergo additional imaging tests or scans to determine the extent of the cancer and plan for surgery.
  • Patient may undergo pre-operative tests and evaluations to ensure they are fit for surgery.

After lumpectomy:

  • Patient undergoes recovery period, with follow-up appointments to monitor healing and address any complications.
  • Pathology report is reviewed to determine if cancer was completely removed and if there are any positive margins.
  • If additional surgery is needed to remove more cancerous tissue, patient may undergo a second lumpectomy or mastectomy.
  • Patient may undergo radiation therapy to reduce the risk of cancer recurrence.
  • Patient may undergo hormonal therapy or chemotherapy as part of their treatment plan.
  • Patient continues with regular follow-up appointments and screenings to monitor for any signs of cancer recurrence.

What to Ask Your Doctor

  1. What is a lumpectomy and why is it recommended for my specific situation?
  2. What is the purpose of taking additional tissue (CSMs) during the lumpectomy procedure?
  3. What are the potential risks and benefits of having CSMs done during my lumpectomy?
  4. How likely is it that I may need additional surgery if cancer is found in the CSMs?
  5. How will the presence of positive margins in the lumpectomy or CSMs affect my recurrence risk and overall survival?
  6. What other treatment options may be recommended based on the results of the lumpectomy and CSMs?
  7. Are there any specific lifestyle changes or follow-up care that I should consider after undergoing a lumpectomy with CSMs?
  8. How often will I need to undergo follow-up screenings and tests to monitor for any signs of recurrence?
  9. What should I do if I notice any changes in my breast tissue or have concerns about my recovery after the surgery?
  10. Are there any clinical trials or research studies that I may be eligible for based on my specific situation and treatment plan?

Reference

Authors: Abdelsattar JM, Afridi FG, Dai Z, Yousaf N, Seldomridge A, Battin AO, Wen S, Gray D, Marsh JW, Cowher MS, Partin JF, Hazard-Jenkins H, Lupinacci K. Journal: Am Surg. 2023 Mar;89(3):424-433. doi: 10.1177/00031348211030464. Epub 2021 Jul 1. PMID: 34196595