ArticleBMJ open2018
Reoperation after breast-conserving surgery for cancer in Australia: statewide cohort study of linked hospital data.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05257577 (Factors Influencing Breast Cancer Resection Volumes And Their Impact on Treatment Outcome), which is not on this map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Factors Influencing Breast Cancer Resection Volumes And Their Impact on Treatment Outcome: a Prospective Multicenter Study (FIBRATIO)
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Does cavity margin shaving reduce residual tumor and re-excision rates? A systematic review.Archives of gynecology and obstetrics · 2023Pooled it
- How equity in cancer services has been defined and measured, and why it matters: a scoping review of Universal Health Coverage systems.Global health action · 2026Article
- Changes in patient management after preoperative MRI for newly diagnosed breast cancer: a multicentre prospective observational study.The Medical journal of Australia · 2025Observational
- Association between hospital volume and survival in patients with locally advanced breast cancer.Breast cancer research and treatment · 2025Article
- Clinicopathological Predictors of Positive Resection Margins in Breast-Conserving Surgery.Annals of surgical oncology · 2024Observational
- Surgical and Radiology Trainees' Proficiency in Reading Mammograms: the Importance of Education for Cancer Localisation.Journal of cancer education : the official journal of the American Association for Cancer Education · 2024Article
- Identification and classification of principal features for analyzing unwarranted clinical variation.Journal of evaluation in clinical practice · 2024Review
- Rates of reoperation after breast conserving cancer surgery in Western Australia before and after publication of the SSO-ASTRO margins guideline.Breast (Edinburgh, Scotland) · 2023Article
- Prospective study: Impact of breast magnetic resonance imaging on oncoplastic surgery and on indications of mastectomy in patients who were previously candidates to breast conserving surgery.Frontiers in oncology · 2023Article
- Tumor margins that lead to reoperation in breast cancer: A retrospective register study of 4,489 patients.Journal of surgical oncology · 2022Article
- Impact of deformation on a supine-positioned image-guided breast surgery approach.International journal of computer assisted radiology and surgery · 2021Article
- Validated prediction model for positive resection margins in breast-conserving surgery based exclusively on preoperative data.BJS open · 2021Article
- The Value of Repeated Breast Surgery as a Quality Indicator in Breast Cancer Care.Annals of surgical oncology · 2021Article
- Textual fiducial detection in breast conserving surgery for a near-real time image guidance system.Proceedings of SPIE--the International Society for Optical Engineering · 2020Article
- Factors Associated with Reoperation in Breast-Conserving Surgery for Cancer: A Prospective Study of American Society of Breast Surgeon Members.Annals of surgical oncology · 2019Article
- Positive or close margins: reoperation rate and second conservative resection or total mastectomy?Cancer management and research · 2019Article
- Tumor deformation correction for an image guidance system in breast conserving surgery.Proceedings of SPIE--the International Society for Optical EngineeringArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate between-hospital variation in the probability of reoperation within 90 days of initial breast-conserving surgery (BCS), and the contribution of health system-level and other factors.
designPopulation-based, retrospective cohort study.
settingNew South Wales (NSW), Australia.
participantsLinked administrative hospitalisation data were used to define a cohort of adult women undergoing initial BCS for breast cancer in NSW between 1 July 2002 and 31 December 2013. PRIMARY OUTCOME MEASURES: Multilevel, cross-classified models with patients clustered within hospitals and residential areas were used to examine factors associated with any reoperation, and either re-excision or mastectomy, within 90 days.
resultsOf 34 458 women undergoing BCS, 29.1% underwent reoperation within 90 days, half of which were mastectomies. Overall, the probability of reoperation decreased slightly over time. However, there were divergent patterns by reoperation type; the probability of re-excision increased alongside a concomitant decrease in the probability of mastectomy. Significant between-hospital variation was observed. Non-metropolitan location and surgery at low-volume hospitals were associated with a higher overall probability of reoperation, and of mastectomy specifically, after accounting for patient-level factors, calendar year and area-level socioeconomic status. The magnitude of association with geographical location and surgical volume decreased over time.
conclusionsReoperation rates within 90 days of BCS varied significantly between hospitals. For women undergoing mastectomy after BCS, this represents a dramatic change in clinical course. Multilevel modelling suggests unwarranted clinical variation may be an issue, likely due to disparities in access to multidisciplinary breast cancer care and preoperative diagnostic procedures. However, the observed reduction in disparities over time is encouraging and indicates that guidelines and policy initiatives have the potential to improve regional breast cancer care.
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