[Secondary breast operations are often necessary and are no indication of poor oncological quality].
The most important factor for tumour recurrence after breast-saving surgery is the margin status. In the Netherlands a 1-mm free margin has been formulated as sufficient, and totally free margins are not necessary in all cases. The current Dutch Health Inspectorate performance indicator, i.e. 10% reexcisions allowed to achieve free margins, is a performance indicator of questionable validity. As long as there is worldwide discussion about the ideal margin in breast-saving surgery a specific norm cannot not be dictated. The aim of the discussion should be how to prevent local recurrence. This percentage is the real performance indicator.
Wobbes
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Universitair Medisch Centrum St Radboud, afd. Heelkunde, Postbus 9101, 6500 HB Nijmegen. t.wobbes@chir.umcn.nl
Schlooz-Vries
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MS
D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control* / Q000601:surgery; D009367:Neoplasm Staging; D009426:Netherlands; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care; D012086:Reoperation; D013514:Surgical Procedures, Operative / Q000379:methods; D017211:Treatment Failure