Margins in breast conserving surgery: The financial cost & potential savings associated with the new margin guidelines.
Breast
; 28: 1-4, 2016 Aug.
Article
in En
| MEDLINE
| ID: mdl-27161409
ABSTRACT
INTRODUCTION:
In this study, we compare the indications for re-excision, the findings of additional tumor in the re-excision specimen as they relate to margin status, and costs associated with re-excision based on recent new consensus statements. MATERIALS ANDMETHODS:
A retrospective analysis was performed on 462 patients with invasive breast carcinoma who underwent at least one lumpectomy between January 2011 and December 2013. Postoperative data was analyzed based on where additional disease was found, as it relates to the margin status of the initial lumpectomy and the additional direct costs associated with additional procedures.RESULTS:
Of the 462 patients sampled, 149 underwent a re-excision surgery (32.2%). Four patients underwent mastectomy as their second operation. In the 40 patients with additional disease found on re-excision, 36 (90.0%) of them had a positive margin on their initial lumpectomy. None of the four mastectomy patients had residual disease. The mean cost of the initial lumpectomy for all 462 patients was $2118.01 plus an additional $1801.92 for those who underwent re-excision.DISCUSSION:
A positive margin was most predictive of finding residual tumor on re-excision as would be expected. Using old criteria only 0.07% (4/61) of patients who had undergone re-excision with a 'clear' margin, had additional tumor found, at a total cost of $106,354.11. Thus, the new consensus guidelines will lead to less overall cost, at no clinical risk to patients while reducing a patient's surgical risk and essentially eliminating delays in adjuvant care.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Reoperation
/
Breast Neoplasms
/
Mastectomy, Segmental
/
Carcinoma, Lobular
/
Carcinoma, Ductal, Breast
Type of study:
Guideline
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
Language:
En
Journal:
Breast
Journal subject:
ENDOCRINOLOGIA
/
NEOPLASIAS
Year:
2016
Type:
Article
Affiliation country:
United States