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Re-excision rates after breast-conserving surgery for invasive breast cancer: an Albertan perspective
Joanna F Ryan1, Sunita Ghosh1, A Nikoo Rajaee1
1From the Division of General Surgery, Department of Surgery, University of Alberta, Edmonton, Alta. (Ryan, Rajaee, Olson, Lesniak, Peiris); the Alberta Health Services Cross Cancer Institute, Department of Medical Oncology, University of Alberta, Edmonton, Alta. (Ghosh); the Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alta. (Ghosh).
Background:
Re-operation after breast-conserving surgery for invasive breast cancer is variable among centres and individual surgeons. In this study, we aimed to characterize the current landscape of practice regarding re-operation for invasive breast cancer in the province of Alberta.
Methods:
This study was a retrospective review of the Synoptec database for patients undergoing primary breast-conserving surgery for invasive breast cancer or reoperation in the province of Alberta in the year 2020. We extracted data on demographic and tumour characteristics, use of intraoperative margin-assessment strategies, and surgical facility. We conducted univariate and multivariate logistic model analyses.
Results:
We included 1391 breast surgeries in the study. A total of 158 patients underwent re-operation during the study period. The median time to first reoperation was 34 days. The overall re-operation rate was 11.4% (range 5.4%-18.5%) among surgical facilities. The completion mastectomy rate was 5.2%, and 1.5% of patients underwent multiple revisional surgeries. Tumour multifocality was associated with increased revisional surgery rates on multivariate analysis (odds ratio 2.80).
Conclusion:
The results of this study are consistent with the published literature. We have identified heterogeneity among sites in Alberta for revisional surgery after breast-conserving surgery for invasive breast cancer. This highlights an opportunity for ongoing education and quality improvement in breast cancer care in the province of Alberta.
