BS's re-excission rate - what's a good/bad number?

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Kitchenwitch
Kitchenwitch Member Posts: 374
edited June 2014 in DCIS (Ductal Carcinoma In Situ)
BS's re-excission rate - what's a good/bad number?
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  • Kitchenwitch
    Kitchenwitch Member Posts: 374
    edited January 2010

    My BS (Kathie Joseph at Columbia-Presbyterian) told me her rate is 30 to 40%. Does that seem high? Should I be worried? Another BS told me hers is 0... but she's in her first year of practice. The other doc I saw said she was very proud of her 18% rate (which I agree sounds quite good). 

    Agonizing over possibility of re-excission, and also worried about biopsy I'm having at the same time. As March 2 date approaches anxiety is starting to bubble over! 

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  • redsox
    redsox Member Posts: 523
    edited January 2010

    I don't know what an optimal re-excision rate is but I do know that the surgeon should be trying to strike a balance between getting all of the cancer the first time and leaving a good enough appearance to be worth preserving the breast.  I would not trust anyone who said her rate was 0%.  The only way to do that is to take very large sections out of the breast.  Even then there are bound to be some cases with DCIS that did not show up on any tests before surgery resulting in the need for re-excision.  Also, there will be cases like mine where there was no indication of cancer before the initial surgery.  The BS found the papilloma she was looking for and removed it.  Pathology showed DCIS without clear margins, leading to re-excision. 

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  • roseg
    roseg Member Posts: 3,133
    edited January 2010

    I wouldn't focus on this.

    Someone with a 0% re-excision could be taking huge chunks out of women, leaving them disfigured when they didn't need to be.  Someone with a high re-excision percentage might be leaving women with the least disfigurement, but with large hospital bills for subsquent surgeries. 

    You can't "see" DCIS in the operating room, and every woman has a different body. I don't think it's a good thing to compare them on.

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  • Leah_S
    Leah_S Member Posts: 8,458
    edited January 2010

    I agree with Rose. When a lumpectomy is done, the tumor and a margin are removed. Reexcision is usually done if that margin has cancer cells within about 2mm of the edge of the portion taken. So the amount around the tumor is probably an educated guess based on the surgeon's experience, the appearance of the tissue, and what s/he knows about the spread of cancer to surrounding tissue.

    Leah

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  • Kitchenwitch
    Kitchenwitch Member Posts: 374
    edited January 2010

    Thanks, everyone. I know the BS I've chosen is board certified, associated with a wonderful hospital and a very caring practice. She spent a long time with me and never looked at her watch or made me feel I was taking up too much time. I think these things are indicative of a doctor's skill and caring - she certainly IS experienced, so it's good to hear that someone's reexcision rate isn't that meaningful. The one with the 0 rate admitted it would go up after she'd been in practice longer. 

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  • Janets1
    Janets1 Member Posts: 57
    edited January 2010

    Hey Kitchenwitch:
    When I went for my second opinion, the "aside" conversation in the room between the breast surgeon and her resident was that she had recently read that Sloan Kettering has a 40% re-excision rate - about par with their practice. So it is very much the norm.

    Jan

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