ANN ARBOR, Mich. Nearly one in three women who have breast cancer surgery will need to return to the operating room for additional surgery after the tumor is evaluated by a pathologist.
A new service at the University of Michigan Comprehensive Cancer Center cuts that number drastically by having pathologists on-site in the operating suite to assess tumors and lymph nodes immediately after they are removed. Meanwhile, the surgeon and patient remain in the operating room until the results are back, and any additional operating can be done immediately.
This cut the number of second surgeries needed by 64 percent, to one of every 10 women.
U-M began offering the service about two years ago at its East Ann Arbor Ambulatory Surgery Center, where the majority of outpatient breast cancer surgeries now occur. A study evaluating 271 patients treated eight months before and 278 treated eight months after this program began appears in the American Journal of Surgery.
"The frequent need for second surgeries among patients undergoing breast cancer surgery represents a tremendous burden for patients. Beyond the inconvenience and additional time away from work, additional surgeries can result in worse cosmetic outcomes and increased complication rates. Our experience shows that offering on-site pathology consultation has a substantial impact on quality of care," says lead study author Michael S. Sabel, M.D., associate professor of surgery at the U-M Medical School.
Patients must return to the operating room for two primary reasons: to remove additional tissue when the cancer cells are too close to the margin of tissue removed; and in some cases, to remove additional lymph nodes if the initial sentinel lymph node biopsy tests positive for cancer.
Before the on-site pathology, 25 percent of patients needed a second operation to remove more tissue, compared to 11 percent after the service began. Among patients wi
|Contact: Nicole Fawcett|
University of Michigan Health System