Rates of re-excision after initial breast-conserving surgery in women with breast cancer remain high across the United States, leading to an increased cost of care and a higher risk of postoperative complications, according to new research from UTHealth Houston.
The study, led by first author Youngran Kim, PhD, assistant professor; and senior author Trudy Krause, PhD, professor, was published in Annals of Surgical Oncology. Both are with the Center for Health Care Data in the Department of Management, Policy and Community Health at UTHealth Houston School of Public Health.
The research team identified 17,129 commercially insured women ages 18-64 and 6,977 Medicare beneficiaries age 18 and older who had initial breast-conserving surgery between 2017 and 2019. The one-year follow-up revealed reoperation rates of 21.1% among commercially insured women and 14.9% among the Medicare cohort. These reoperations correlated with a 24% increase in costs for both the commercial and Medicare cohorts, translating into incremental expenses of $21,607 and $8,559, respectively. Furthermore, reoperations were linked to a 54% increased risk of complications in the commercial cohort and an 89% elevated risk in the Medicare cohort.
The study also found that younger age and ductal carcinoma in situ were associated with a higher reoperation rate, while the use of neoadjuvant chemotherapy and immediate oncoplastic surgery were associated with a lower reoperation rate.
