Risk Factors for Re-excision Following Breast Conserving Surgery in North Texas

Introduction: Breast-conserving surgery (BCS) is a common treatment available to patients with Ductal Carcinoma In Situ (DCIS) and early stage invasive breast cancer. A significant number of women who undergo BCS treatment may need to have a second excision or eventual mastectomy in order to obtain clear margins. Re-excision rates range anywhere from 7-30% with an average of about 20%. Objectives: The purpose of this project is to identify and quantify factors for re-excision following a BCS approach to breast cancer. Methods: The study is a retrospective secondary data analysis using data from the Texas Health Fort Worth's Cancer Registry. Statistical analysis of 244 BCS patients from 2011-2012 was performed using SPSS 20. Results: A model with 87% accuracy was constructed from three significant factors. Time in days between surgery and diagnosis was a significant factor, increasing the odds of re-excision 1% per day. The Odds Ratio (OR) for Surgery with Dye was OR= 0.12 with a 95% Confidence Interval (CI) of 0.051 to 0.283. The odds ratio for those over the age of 50 was OR=0.282 with CI= 0.091 to 0.869. Conclusions: The model predicts that women over the age of 50 with a surgical approach using dye or needle localization who undergo surgery soon after diagnosis are the least likely to require additional surgery after BCS.