Reoperations after primary breast conserving surgery in women with invasive breast cancer in Catalonia, Spain: a retrospective study.
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.
Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain. jmescriba@iconcologia.net.|Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, L' Hospitalet de Llobregat, Barcelona, Spain. jmescriba@iconcologia.net.
J M
JM
Escribà
Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain.
L
L
Esteban
Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain.
J
J
Gálvez
Breast Cancer Functional Unit, Catalan Institute of Oncology, L' Hospitalet de Llobregat, Barcelona, Spain.
M J
MJ
Pla
Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain.
A
A
Melià
Breast Cancer Functional Unit, Catalan Institute of Oncology, L' Hospitalet de Llobregat, Barcelona, Spain.
M
M
Gil-Gil
Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain.|Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, L' Hospitalet de Llobregat, Barcelona, Spain.
R
R
Clèries
Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain.
L
L
Pareja
Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain.
X
X
Sanz
Divisió d'Anàlisi de la Demanda i l'Activitat, Department of Health, Generalitat de Catalunya, Catalan Health Service, Barcelona, Spain.
M
M
Bustins
Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain.|Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, L' Hospitalet de Llobregat, Barcelona, Spain.
J M
JM
Borrás
Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain.|Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, L' Hospitalet de Llobregat, Barcelona, Spain.
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Ribes
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology
Invasive breast neoplasm; Local recurrence; Partial mastectomy; Re-excision; Surgical margins