Toolbox to reduce lumpectomy reoperations and improve cosmetic outcome in breast cancer catients: The American Society of Breast Surgeons consensus conference Journal Article
| Authors: | Landercasper, J.; Attai, D.; Atisha, D.; Beitsch, P.; Bosserman, L.; Boughey, J.; Carter, J.; Edge, S.; Feldman, S.; Froman, J.; Greenberg, C.; Kaufman, C.; Morrow, M.; Pockaj, B.; Silverstein, M.; Solin, L.; Staley, A.; Vicini, F.; Wilke, L.; Yang, W.; Cody, H. S. 3rd |
| Article Title: | Toolbox to reduce lumpectomy reoperations and improve cosmetic outcome in breast cancer catients: The American Society of Breast Surgeons consensus conference |
| Abstract: | Background: Multiple recent reports have documented significant variability of reoperation rates after initial lumpectomy for breast cancer. To address this issue, a multidisciplinary consensus conference was convened during the American Society of Breast Surgeons 2015 annual meeting. Methods: The conference mission statement was to “reduce the national reoperation rate in patients undergoing breast conserving surgery for cancer, without increasing mastectomy rates or adversely affecting cosmetic outcome, thereby improving value of care.” The goal was to develop a toolbox of recommendations to reduce the variability of reoperation rates and improve cosmetic outcomes. Conference participants included providers from multiple disciplines involved with breast cancer care, as well as a patient representative. Updated systematic reviews of the literature and invited presentations were sent to participants in advance. After topic presentations, voting occurred for choice of tools, level of evidence, and strength of recommendation. Results: The following tools were recommended with varied levels of evidence and strength of recommendation: compliance with the SSO-ASTRO Margin Guideline; needle biopsy for diagnosis before surgical excision of breast cancer; full-field digital diagnostic mammography with ultrasound as needed; use of oncoplastic techniques; image-guided lesion localization; specimen imaging for nonpalpable cancers; use of specialized techniques for intraoperative management, including excisional cavity shave biopsies and intraoperative pathology assessment; formal pre- and postoperative planning strategies; and patient-reported outcome measurement. Conclusions: A practical approach to performance improvement was used by the American Society of Breast Surgeons to create a toolbox of options to reduce lumpectomy reoperations and improve cosmetic outcomes. © 2015, The Author(s). |
| Keywords: | treatment outcome; excision; surgical technique; histopathology; treatment planning; cancer patient; nuclear magnetic resonance imaging; cancer diagnosis; preoperative evaluation; consensus; breast cancer; radiation; practice guideline; diagnostic imaging; patient care; adverse outcome; radiology; mammography; intraoperative period; echography; needle biopsy; cancer size; partial mastectomy; surgeon; reoperation; medical society; intraductal carcinoma; breast biopsy; clinical assessment tool; digital imaging; minimally invasive procedure; breast calcification; tumor invasion; breast q; human; article; shave biopsy; excisional cavity; minimally invasive breast biopsy; oncoplastic technique |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 22 |
| Issue: | 10 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2015-10-01 |
| Start Page: | 3174 |
| End Page: | 3183 |
| Language: | English |
| DOI: | 10.1245/s10434-015-4759-x |
| PROVIDER: | scopus |
| PMCID: | PMC4550635 |
| PUBMED: | 26215198 |
| DOI/URL: | |
| Notes: | Export Date: 2 October 2015 -- Source: Scopus |
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