ArticleAnnals of surgical oncology2019
Factors Associated with Reoperation in Breast-Conserving Surgery for Cancer: A Prospective Study of American Society of Breast Surgeon Members.
Article in Annals of surgical oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Fluorescence guided surgery imaging systems for breast cancer identification: a systematic review.Journal of biomedical optics · 2024Pooled it
- The INTEND 1 randomized controlled trial of duct endoscopy as an indicator of margin excision in breast conservation surgery.Breast cancer research and treatment · 2021Trial
- L-ICG as an optical agent to improve intraoperative margin detection in breast-conserving surgery: a prospective study.Breast cancer research and treatment · 2025Article
- Intraoperative Examination of Retro-Areolar Margin is not Routinely Necessary During Nipple-Sparing Mastectomy for Cancer.Annals of surgical oncology · 2023Article
- Surgeon Factors Influencing Breast Surgery Outcomes: A Scoping Review to Define the Modern Breast Surgical Oncologist.Annals of surgical oncology · 2023Article
- Breast-Conserving Surgery Margin Guidance Using Micro-Computed Tomography: Challenges When Imaging Radiodense Resection Specimens.Annals of surgical oncology · 2023Article
- Article
- Dual-Layer Rotation: A Versatile Therapeutic Mammoplasty Technique.Annals of surgical oncology · 2022Article
- Economic Impact of Reducing Reexcision Rates after Breast-Conserving Surgery in a Large, Integrated Health System.Annals of surgical oncology · 2022Article
- Emerging and future use of intra-surgical volumetric X-ray imaging and adjuvant tools for decision support in breast-conserving surgery.Current opinion in biomedical engineering · 2022Article
- Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA).European radiology · 2022Observational
- Characteristics of Exceptionally Good Doctors: A Protocol for a Cross-Sectional Survey of Adults.Patient related outcome measures · 2022Article
- Is There a Surgeons' Effect on Patients' Physical Health, Beyond the Intervention, That Requires Further Investigation? A Systematic Review.Therapeutics and clinical risk management · 2022Review
- Qualitative Study of Medical Doctors on Their Experiences and Opinions of the Characteristics of Exceptionally Good Doctors.Advances in medical education and practice · 2022Article
- The Doctors' Effect on Patients' Physical Health Outcomes Beyond the Intervention: A Methodological Review.Clinical epidemiology · 2022Article
- Innovative Standards in Surgery of the Breast after Neoadjuvant Systemic Therapy.Breast care (Basel, Switzerland) · 2021Review
- Developing diagnostic assessment of breast lumpectomy tissues using radiomic and optical signatures.Scientific reports · 2021Article
- A New Look into Cancer-A Review on the Contribution of Vibrational Spectroscopy on Early Diagnosis and Surgery Guidance.Cancers · 2021Review
- Margin Assessment and Re-excision Rates for Patients Who Have Neoadjuvant Chemotherapy and Breast-Conserving Surgery.Annals of surgical oncology · 2021Article
- The Value of Repeated Breast Surgery as a Quality Indicator in Breast Cancer Care.Annals of surgical oncology · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundMore than 20% of patients undergoing initial breast-conserving surgery (BCS) for cancer require reoperation. To address this concern, the American Society of Breast Surgeons (ASBrS) endorsed 10 processes of care (tools) in 2015 to be considered by surgeons to de-escalate reoperations. In a planned follow-up, we sought to determine which tools were associated with fewer reoperations.
methodsA cohort of ASBrS member surgeons prospectively entered data into the ASBrS Mastery
resultsSeventy-one surgeons reported reoperations in 486 (12.3%) of 3954 cases (mean 12.7% [standard deviation (SD) 7.7%], median 11.5% [range 0-32%]). There was an eightfold difference between surgeons in the 10th and 90th percentile performance groups. Actionable factors associated with fewer reoperations included routine planned cavity side-wall shaves, surgeon use of ultrasound (US), neoadjuvant chemotherapy, intra-operative pathologic margin assessment, and use of a pre-operative diagnostic imaging modality beyond conventional 2D mammography. For patients with invasive cancer, ≥ 24% of those who underwent reexcision did so for reported margins of < 1 or 2 mm, representing noncompliance with the SSO-ASTRO margin guideline.
conclusionsAlthough ASBrS member surgeons had some of the lowest rates of reoperation reported in any registry, significant intersurgeon variability persisted. Further efforts to lower rates are therefore warranted. Opportunities to do so were identified by adopting those processes of care, including improved compliance with the SSO-ASTRO margin guideline, which were associated with fewer reoperations.
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