Can second breast cancer surgery be prevented?

Removing extra slice around margins might avert additional breast cancer operation

The flip-floppers are back.

Actually, that's misleading. They never went away.

Flip-flops in breast cancer research date back almost as far as research in breast cancer itself. They resemble my reference in "Rollercoaster: How a man can survive his partner's breast cancer" to the medical profession forever changing its mind on breast and bottle feeding.

Anyway, it seems the latest study says there's a benefit to more extensive — rather than less — breast cancer surgery, to ensure margins being clear.

According to a recent Associated Press story by Marilynn Marchionne, cavity shaving (which means "routinely removing an extra thin slice all around the margins," the areas surrounding the place the cancer was found) is a way of lowering the risk by 50 percent of women requiring a second surgery.

The article indicates that the study "could change care for more than 100,000 women in the United States alone each year."

Dr. Anees Chagpar

It quotes the study's leader, Dr. Anees Chagpar of the Yale Cancer Center, as saying, "When you think about the emotional impact, let alone the economic impact, of those second surgeries, that's a big deal."

The new findings were disclosed in a study discussed at an American Society of Clinical Oncology meeting in Chicago and published online by the New England Journal of Medicine.

Currently, between 20 and 50 percent of women wind up with positive margins and need additional surgeries.

But cancer specialists for a long time have sworn by the concept of taking the least amount of tissue possible. 

Flip-flop, anyone?