High rates of follow up surgeries found in breast cancer patients

Almost 30% of women who undergo breast-conserving surgery in early stage breast cancer require reoperation, involving either re-excision or a complete mastectomy, according to Australian research.

18,000 women are diagnosed with breast cancer every year.

Of those who opt for early surgery 3000 will be told the inital operation was unsuccessful at removing all the cancers cells and they'll need another operation.

A study of 34 458 women in New South Wales undergoing breast-conserving surgery (BCS), found 29.1% had further operations within 90 days, half of which were mastectomies.

The research was done by Dr Marina T van Leeuwen and Associate Professor Claire M Vajdic from the Centre for Big Data Research in Health, at the University of New South Wales.

Breast-conserving surgery is also known as a lumpectomy. It's an option for women with early stage breast cancer and is a partial mastectomy followed up with radiotherapy.

Speaking to your surgeon about the potential for follow up surgery is incredibly important Dr van Leeuwen told the Australian Financial Review.

"If I was sitting across from the breast surgeon, I would want to know if I was a suitable candidate for breast-conserving surgery, given my type of tumour and given the available services."

More information about best practice in breast cancer treatment can be found at Cancer Australia.

Regional variations

The researchers also found variations depending on where someone lives.

"Women who resided in non-metropolitan areas and who attended non-metropolitan hospitals were more likely to undergo completion mastectomy than their metropolitan counterparts, as were women attending low volume hospitals. This suggests that unwarranted clinical variation may be an issue."

The findings aren't a reflection on the quality of medical care, rather the availability of quality diagnostic tools outside major metropolitan hospitals to accurate detect tumours earlier

"Women in non-metropolitan areas have lower rates of mammographic screening participation; they may have been less likely, therefore, to have been referred for fine-needle aspiration or core biopsy, and instead, more likely to have undergone surgical biopsy. Surgical biopsy is itself associated with higher rates of reoperation, as it is performed for diagnostic purposes rather than with the intention of complete excision."

There is some good news though. Disparities in reoperation rates between metropolitan and non-metropolitan areas, seems to have reduced, which suggests care in regional areas is improving.

"This is encouraging and suggests that policy initiatives to improve regional breast cancer care in NSW over the past decade may have had some success."