New surgical guidelines have potential to reduce unnecessary breast surgeries, improve patient outcomes

New surgical guidelines announced today by the Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) have the potential to significantly reduce unnecessary breast surgeries, improve patient outcomes and empower women to make important decisions with their doctors about their breast cancer treatment. The new guidelines are the result of a Komen-funded comprehensive review of the value of removing large amounts of breast tissue beyond the "margins" or area around the edge of a cancerous breast tumor.

SSO and ASTRO noted that about 25 percent of breast cancer patients are asked to return to the operating room following a lumpectomy to obtain a wider margin by removing more normal tissue around the cancer, known as "re-excision" of the breast.

Whether this second procedure is beneficial in reducing the risk of local recurrence, and how much tissue should be removed, has been a topic of ongoing debate in the medical community. To answer this question, Komen provided funding to Dr. Monica Morrow of the SSO to convene leaders in surgical oncology, radiation oncology, medical oncology, pathology and patient advocacy, including representation from Komen's Advocates in Science (AIS) member Peggy Johnson. The panel convened in 2013 to determine the optimal margin width in breast-conserving surgery for stage I and II invasive breast cancer.

The findings announced today show that evidence does not support the routine removal of larger amounts of healthy breast tissue beyond the edge of the tumor for any women, including those with aggressive triple negative breast cancer. SSO and ASTRO are releasing the guidelines to doctors and oncologists today in hopes of influencing clinical practice.

"One of our most important goals is ensuring that breast cancer patients get the right treatment for them, and can make informed choices about their care. We hope these guidelines can reduce anxiety, unnecessary re-excisions and even patient treatment costs. They should become an important part of the discussion between a woman and her medical team," said Komen President and CEO Judith A. Salerno, M.D., M.S.

Peggy Johnson, a Komen Advocate in Science, commended the panel for its thoughtful review of the issue. "There are so many decisions that a patient has to make after a breast cancer diagnosis. Our goal as patient advocates is to ensure that patients are informed and consulted, and that they are making decisions based on the best evidence available. I was honored as a patient advocate to serve on this panel, and look forward to more collaborations for the benefit of women and men facing breast cancer."

With more than $33 million invested in research on improved screening and diagnostic methods and $37.5 million invested in understanding how to improve patient quality of life, these guidelines build upon Komen's commitment to ensuring quality care for all patients and leading the future of breast cancer research.

Advancing patient knowledge and representation throughout the breast cancer continuum of care also continues to be a key area of focus for Komen. Through groups like the AIS, established in 2008, patient advocates bring a real-world understanding of what most impacts those affected by breast cancer, and an urgency to find cures and more effective prevention, diagnosis and treatment.