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Reoperations after primary breast conserving surgery in women with invasive breast cancer in Catalonia, Spain: a retrospective study

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Abstract

Background

Although complete tumor resection is accepted as the best means to reduce recurrence, reoperations after lumpectomy are a common problem in breast cancer. The aim of this study was to assess the reoperation rates after primary breast conserving surgery in invasive breast cancer cases diagnosed in Catalonia, Spain, between 2005 and 2011 and to identify variations based on patient and tumour characteristics.

Methods

Women with invasive incident breast cancer identified from the Patient’s Hospital Discharge Database [174.0–174.9 codes of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as the primary diagnosis] and receiving primary breast conserving surgery were included in the study and were followed up to 3 and 12 months by collecting information about repeat breast cancer surgery.

Results

Reoperation rates after primary breast conserving surgery decreased from 13.0 % in 2005 to 11.7 % in 2011 at 3 months and from 14.2 % in 2005 to 12.9 % in 2011 at 12 months’ follow-up. While breast conservation reoperations saw a slight, non-significant increase in the same period (from 5.7 to 7.3 % at 3 months, and from 6.0 to 7.5 % at 12 months), there was a significant decrease in radical reoperation (from 7.3 to 4.4 % at 3 months and from 8.2 to 5.4 % at 12 months). Overall, additional breast surgeries decreased among younger women.

Conclusions

Despite the rise of breast conserving surgery, reoperation rates following initial lumpectomy in Catalonia decreased by 10 % at 3 and 12 months’ follow-up, remaining low and almost unchanged. Ultimately, there was also a significant decrease in mastectomies.

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Abbreviations

BC:

Breast cancer

BCS:

Breast conserving surgery

LR:

Local recurrence

HDD:

Hospital discharge database

PHIN:

Personal health identification number

ICD-9-CM:

International Classification of Diseases, 9th revision, Clinical Modification

ASEDAT:

Analysis, selection and extraction of tumor data

IARC:

International Agency for Research on Cancer

CIS:

Carcinoma in situ

CCI:

Charlson comorbidity index

AJCC:

American Joint Committee on Cancer

AsBrS:

American Society of Breast Surgeons

SSO:

Society of Surgical Oncology

ASTRO:

American Society for Radiation Oncology

ALND:

Axillary lymph node dissection

SLNB:

Sentinel lymph node biopsy

ICD-10-CM/PCS:

International Classification of Diseases, 10th revision, Clinical Modification and Procedure Classification System

OPCS-4:

OPCS classification of interventions and procedures version 4

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Acknowledgments

We thank MB and the Catalan Health Department for providing the original data. This study was partially funded by the Institute of Health Carlos III (RTICC: RD12/0036/0053), within the framework of the National Plan of I+D+I 2013-2016 and the European Regional Development Fund (FEDER: a way to build Europe) and the Agència de Gestió d’Ajuts Universitaris I de Recerca–Generalitat de Catalunya (Catalonian Government; Grant Number AGAUR, 2014SGR0635).

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Correspondence to J. M. Escribà.

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The authors have no conflicts of interest to declare. I wish to confirm that all the authors have carefully read the manuscript and fully approved it. On their behalf, I also state that the manuscript is original and it has not been submitted to other journal. Finally, I wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Informed consent

Informed consent was not required because we used administrative databases with anonymized information to the researchers.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Escribà, J.M., Esteban, L., Gálvez, J. et al. Reoperations after primary breast conserving surgery in women with invasive breast cancer in Catalonia, Spain: a retrospective study. Clin Transl Oncol 19, 448–456 (2017). https://doi.org/10.1007/s12094-016-1546-5

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