Breast cancer surgery in the NHS is a ‘postcode lottery’ of success, according to a nationwide survey of reoperation rates in England.
Over half of breast cancer patients choose to have breast conserving surgery rather than have the whole breast removed (mastectomy). When combined with radiotherapy, breast-conserving therapy produces similar survival rates to a mastectomy.
However, difficult to detect tumours sometimes mean that breast conserving surgery is not completely successful. A re-operation may be needed to remove all the cancer.
Researchers from the UK looked at data collected from the Hospital Episode Statistics (HSE) database. It involved 55,297 women with breast cancer who underwent breast-conserving surgery in the NHS between 2005 and 2008.
The total reoperation rate for invasive breast cancer averaged 18 per cent.
However, the rate varied substantially across the 156 NHS trusts.
In the top ten per cent of trusts, the reoperation rate averaged 12.2 per cent. In the bottom 10 per cent it averaged 30.2 per cent.
The authors of the study cited ‘poor surgical technique’ as a possible reason, as well as patient preferences for alternative treatment options. Surgeons should take at least 5mm of healthy tissue around a breast cancer tumour, but in practise some take double to be on the safe side.
A reoperation means a full mastectomy in four out of 10 cases.
Dr Siobhan McClelland, of Macmillan Cancer Support, said: “Nobody wants to go through the emotional strain of unnecessary surgery or mastectomies. This is why breast conserving surgery has become more popular.
"But it is essential that oncologists ensure that breast cancer patients are made aware of all of their treatment options and their possible result before any decision is made.”
“However, this should not undermine what the surgeons are doing – it also shows that 80 per cent of breast conserving surgery is successful.”
Many people take out a health insurance policy with full cancer cover to avoid the NHS postcode lottery.
© ActiveQuote Ltd. 2012