Lumpectomies can lead to repeat surgeries

There's important new research out about breast cancer.

A study in the Journal of the American Medical Association found almost a quarter of the women who got a lumpectomy went back for more surgery. That may not have been necessary.

CBS News correspondent Elaine Quijano reports that when Donna Marano learned she had breast cancer in 2008, she chose a lumpectomy to remove her tumor and preserve as much of her breast as possible. Just one month later she had to undergo a second procedure.

"We didn't believe there was any more cancer cells, but to be safe, decided to go in and remove it," Marano said.

Today's study showed that nearly one out of four breast cancer patients had the same experience as Marano. It also raises questions about whether some of these procedures are necessary. Dr. Laurence McCahill led the study, and says there is no standard guideline for when there should be a follow up procedure.

"Is lumpectomy and the decision for a second operation fairly uniform across the country? We found that it wasn't, that there's quite a lot of variability from hospital to hospital and also among individual surgeons," McCahill said.

During a lumpectomy, surgeons try to remove the entire tumor and the cells surrounding it to get what's called a "clean margin." That means there are no cancer cells in the tissue surrounding the tumor. Researchers studied more than 2,200 women who had lumpectomies, and the criteria for re-operation differed dramatically: 48 percent of women with a clean margin within one millimeter around the tumor still had repeat surgeries; 20 percent had a margin of up to two millimeters and were still re-operated on.

With no set guidelines the decision to re-operate comes down to each surgeon. Dr. McCahill says their competence and level of experience vary greatly, and that the very idea of having a second surgery has serious consequences.

"Sometimes women are frustrated enough by a second operation that a percentage of them, maybe half, will just elect to move forward with a mastectomy or a removal of the whole breast," McCahill said.

Perhaps more disturbing, 14 percent in the study showed evidence of cancer left behind after the first surgery, but didn't go in for a second procedure.

  • Elaine Quijano

    Elaine Quijano was named a CBS News correspondent in January 2010. Quijano reports for "CBS This Morning" and the "CBS Evening News," and contributes across all CBS News platforms. She is based in New York.