Quality of life and decision satisfaction after re-excision in breast cancer surgery

The literature reports positive margin rates after breast conserving surgery (BCS) as high as 20-60 ​%, often necessitating re-excision, which may negatively influence patients. This study evaluates how re-excision affects quality-of-life and decision satisfaction.

Patients who underwent re-excision following BCS from January 2013 to December 2015 ​at a single institution were surveyed on physical, social, and emotional wellbeing, as well as satisfaction with their initial surgical decision. Descriptive statistics and the Wilcoxon Rank Sum Test were used for analysis.

Among 106 patients, 51 (48.1 ​%) completed the survey. Quality of life declined in all categories following re-excision, with a significant reduction in emotional wellbeing (p ​= ​0.006). Decision satisfaction to undergo partial mastectomy decreased from 76.5 ​% to 47.1 ​%, while dissatisfaction rose from 2 ​% to 11.8 ​%.

Re-excision was associated with decreased emotional wellbeing and increased decision dissatisfaction with breast conservation. These findings emphasize the need to optimize preoperative counseling and margin control during the primary surgery to enhance patient experience.