JEFFREY LANDERCASPER, MD

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This study looked at ways to reduce the number of women who need additional surgery after breast-conserving surgery (BCS) for cancer, testing a statewide plan in Wisconsin. They found that hospitals participating in the program saw a significant decrease in re-excision rates, dropping from about 16.1% to a lower number, while non-participating hospitals did not experience a change. This is important because lowering the need for follow-up surgeries can improve patient outcomes and lower healthcare costs. Who this helps: This helps patients undergoing breast-conserving surgery.

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This study looked at how women with breast cancer feel about being called "cancer survivors." It found that while some like the term for its positive connotation, many others find it unsuitable or offensive. The researchers argue that patients should have a say in the labels used to describe their experiences, emphasizing that using the wrong words can have negative effects on their mental health. Who this helps: This helps cancer patients and their healthcare providers.

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This study looked at how a new guideline from two medical organizations affected the need for additional surgeries after breast cancer patients had their first lumpectomy. Researchers found that the rate of patients needing a second surgery dropped from 22% to 14% after the guideline was introduced, indicating a 35% reduction in the chances of having to go through another operation. This is important because it means that fewer patients will have to face additional surgeries, which can be stressful and have other risks. Who this helps: This helps breast cancer patients by reducing the need for reoperations after their initial treatment.

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This study looked at how well patients with breast cancer do after having either a lumpectomy or a mastectomy, using data from over 845,000 patients. It found that for most stages of breast cancer, the overall survival rate after mastectomy was similar to that after lumpectomy, with a slight edge for lumpectomy in certain cases: patients with stage I cancer had a 27% higher survival rate with lumpectomy, while stage III patients had an 17% better survival rate with mastectomy. This information is important because it helps doctors and patients make informed choices about breast cancer surgery options. Who this helps: This helps patients and their doctors when deciding on breast cancer treatment.

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This study looked at factors that can lead to fewer second surgeries after breast-conserving surgery for cancer. Researchers found that about 12.3% of patients needed to go back for another operation, and some surgeons had rates as high as 32%. They identified specific practices, like using ultrasound and checking the surgical margins during surgery, that can help lower the chances of needing a reoperation, emphasizing the importance of following established guidelines. Who this helps: This helps patients undergoing breast cancer treatment and their surgeons.

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This study looked at the rates of repeat surgeries after breast-conserving surgery (BCS) for cancer, analyzing data from over 524,000 patients across 1,226 facilities between 2004 and 2015. It found that 16.1% of patients had to undergo a repeat surgery, with the most significant factor influencing this being the specific facility where the surgery was performed. Furthermore, after implementing new guidelines, the number of repeat surgeries decreased, but only one in four hospitals met the recommended target of keeping these rates below 10%. Who this helps: This helps patients undergoing breast cancer surgery by highlighting facilities that perform better and encouraging improvements in surgical practices.

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This paper addresses factors that lead to patients needing additional surgery after breast-conserving surgery for cancer. The authors found that certain factors, such as the size of the tumor and surgical technique, increased the chances of needing a second operation, with reoperation rates affecting up to 25% of patients in some cases. Understanding these factors is important for improving surgical outcomes and minimizing the need for repeat surgeries. Who this helps: This helps patients undergoing breast-conserving surgery and their doctors.

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This study looked at how well breast surgeons met certain quality standards for breast cancer care between 2011 and 2015, analyzing over a million patient encounters. The results showed that while most surgeons performed well, with high rates like 98.5% for needle biopsies and 99.4% for antibiotic selection, there were still areas for improvement, particularly as some quality measures aimed for a perfect 100%. The findings matter because they highlight both the strengths and weaknesses in breast cancer treatments, guiding surgeons to improve care standards. Who this helps: Patients with breast cancer benefit from improved treatment quality.

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This study looked at how well different surgeons perform lumpectomies for breast cancer by combining rates of reoperations and patient satisfaction with cosmetic outcomes. The research found that three surgeons had different reoperation rates—9.5%, 13.0%, and 16.3%—but overall, about 10.4% of patients required a second surgery. Patients also reported their satisfaction with cosmetic results, with 55% rating them as excellent. This matters because it provides patients with a clearer way to choose their surgeon based on quality measures that matter to them. Who this helps: Patients seeking information to make informed choices about their breast cancer surgery.

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This study looked at how to manage non-cancerous breast conditions, which affect up to 50% of women, and created a list of five key recommendations for doctors based on expert opinions. The findings include: (1) no need to remove certain non-symptomatic growths, (2) leave small fibroadenomas alone, (3) try to drain breast abscesses without surgery first, (4) avoid screening mammograms in asymptomatic patients with a short life expectancy, and (5) do not drain non-painful cysts. These guidelines aim to reduce unnecessary procedures and improve discussions between patients and doctors about breast health. Who this helps: This helps patients by reducing unnecessary treatments and improving care for benign breast conditions.

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The study focused on improving how doctors follow updated guidelines about lab testing for early breast cancer patients. After changing the guidelines in June 2016 to stop routine blood tests for patients who showed no symptoms, the researchers successfully tracked compliance and found that 82% of doctors followed the new guidance for complete blood counts, and 87% for liver function tests, demonstrating a quicker adoption compared to past practices. This is important because it helps reduce unnecessary tests, saving time and resources while still ensuring effective patient care. Who this helps: This helps patients with early breast cancer and their healthcare providers.

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This paper explored why some patients need additional surgery after a lumpectomy for breast cancer while others do not. The study made a mistake in referencing the Massachusetts General Hospital but focused on the reasons behind the differences in reoperation rates. Understanding these factors can improve treatment planning and outcomes for breast cancer patients. Who this helps: This helps breast cancer patients and their doctors.

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This study focuses on updating a set of guidelines created by the American Society of Breast Surgeons to reduce the number of patients needing additional surgery after a lumpectomy. The updated toolbox now includes new information and techniques that help ensure surgeons remove all cancerous tissue during the first surgery, which can improve outcomes and reduce the likelihood of patients needing a second operation. This matters because it can improve patient satisfaction and reduce stress and costs associated with multiple surgeries. Who this helps: Patients undergoing breast cancer treatment.

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Researchers studied whether new guidelines for breast cancer surgery reduced the number of patients needing a second surgery after their first attempt to remove a tumor. They found that the overall rate of second surgeries dropped from 20.2% to 16.5%, and specifically, surgeries for tumors with close margins decreased by 13.8%. This is important because fewer follow-up surgeries can lead to less stress and better outcomes for patients. Who this helps: Patients undergoing breast-conserving surgery for early-stage invasive cancer.

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This study looked at how the timing of chemotherapy affects the need for additional surgeries after a lumpectomy for breast cancer. It found that patients who received chemotherapy before their surgery (neoadjuvant chemotherapy) had a reoperation rate of 11.4%, while those who had chemotherapy afterward (adjuvant chemotherapy) had a much higher rate of 20.3%. This is significant because it shows that getting chemotherapy before surgery can lead to fewer follow-up surgeries, which can improve patient outcomes. Who this helps: This benefits breast cancer patients and their doctors by providing a better treatment strategy.

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This study examined how neoadjuvant chemotherapy (NAC), given before breast cancer surgery, impacted complications after surgery for patients undergoing lumpectomy or mastectomy. Out of over 30,000 patients, those who had NAC before lumpectomy between 2011 and 2012 experienced significantly higher complications and death rates, with a risk nearly 2.6 times greater compared to those who did not receive NAC. This finding is important because it highlights potential risks of NAC prior to surgery and suggests the need for closer monitoring and further research on how chemotherapy affects patient outcomes. Who this helps: This information is valuable for patients considering breast cancer treatment options and their doctors.

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The American Society of Breast Surgeons created a program to improve the quality of surgical care for breast cancer patients by developing specific measures to track how well surgeons are performing. They evaluated over 1 million patient encounters from 2010 to 2015, ultimately identifying 9 key quality measures that include important factors like cancer diagnosis methods and infection rates. This program is important because it helps ensure that surgeons meet high standards, leading to better patient outcomes. Who this helps: This benefits breast cancer patients and their surgeons by improving surgical care quality.

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This study looked at whether a risk calculator used by surgeons is effective for predicting problems in breast cancer patients who have breast-conserving surgery. Out of 287 patients studied, 13.9% ended up needing to go back into surgery for cancer-related reasons, which was higher than what the calculator predicted. This discrepancy indicates that the calculator might not fully capture the risks specific to these patients, making it important to reconsider how it is used in discussions before surgery. Who this helps: This helps doctors and surgeons who work with breast cancer patients.

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This study investigated whether using local or regional anesthesia instead of general anesthesia improves outcomes for breast cancer patients undergoing surgery. The researchers looked at over 1,100 patients and found that survival rates and cancer-free rates at five years were quite similar between the two groups: 85.5% survival for general anesthesia compared to 87.1% for local anesthesia, and similarly comparable rates for disease-free survival and local recurrence. These results indicate that the type of anesthesia used doesn’t significantly impact the long-term outcomes for breast cancer patients. Who this helps: This information benefits breast cancer patients and their doctors by clarifying that anesthesia choice may not affect surgical outcomes.

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This study looked at how breast cancer survivors feel about receiving their diagnosis and test results. Out of 784 patients surveyed, only 39% received their diagnosis face-to-face, while 50% preferred this method. Furthermore, 40% received their biopsy results within 2 days, but 82% wanted this quick turnaround. These findings highlight that patients aren't getting the kind of communication they want, suggesting a need for healthcare improvements. Who this helps: This helps breast cancer patients by advocating for better communication from their doctors.

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This study examined the care practices in breast cancer treatment to identify which procedures might be unnecessary. The American Society of Breast Surgeons created a list of five specific measures, such as not routinely ordering MRIs for new patients or performing double mastectomies when only one breast has cancer. These recommendations aim to help improve decision-making between doctors and patients while preventing unneeded tests and surgeries. Who this helps: This helps breast cancer patients and their surgeons.

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This study looked at nearly 130,000 women with early-stage breast cancer to see how a 21-gene test affected their chances of getting chemotherapy. It found that nearly 60% of those tested had low-risk scores and were less likely to receive chemotherapy, while those with intermediate and high-risk scores were much more likely to do so—87 times more likely for high-risk patients. This matters because the test can help doctors and patients make better treatment decisions based on cancer risk, potentially avoiding unnecessary chemotherapy for those at low risk. Who this helps: This helps patients with early-stage breast cancer by guiding treatment decisions.

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Researchers looked at breast MRIs of 316 patients with known breast cancer from 2009 to 2014 to find other abnormal findings outside the breast. They discovered that 59% of the MRIs contained these extra findings, with 89% of them being benign and 11% malignant; specific cancers identified included thyroid and lung cancers and metastatic nodes. The extra findings frequently led to additional tests and procedures, costing patients an average of $2,206 each, which highlights the financial burden of these unnecessary evaluations. Who this helps: This information is beneficial for patients with breast cancer and their doctors as it helps them understand the potential implications of MRI findings.

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This study looked at how well a hospital followed the National Comprehensive Cancer Network (NCCN) guidelines for treating breast cancer in 395 patients diagnosed between 2010 and 2011. The results showed high compliance rates: 94% for staging evaluations, 97% for surgery, and 85% for follow-up care, among others. Understanding why some patients did not receive recommended treatments—like patient refusal or personal choices—helps improve cancer care practices and quality. Who this helps: This helps patients and doctors improve breast cancer treatment by ensuring guidelines are followed.

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This study looked at whether having surgical residents assist in breast cancer surgeries affected patients' outcomes. Out of 1,107 patients, about 80% had resident participation in their surgeries, which did result in longer surgery times, but there were no differences in complications, the need for follow-up surgeries, or the rates of cancer returning. This finding is important because it shows that having residents involved does not harm patient outcomes, which can help reassure both patients and surgeons. Who this helps: This helps patients and doctors who are involved in breast cancer treatment.

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This study looked at how effective Twitter is for educating and supporting women with breast cancer. Out of 206 participants, 92.7% were female, and many reported significant gains in their understanding of breast cancer topics, like survivorship (85.7%) and treatment options (55.6%). Additionally, after joining the Twitter support group, 67% of those who felt very anxious saw their anxiety levels drop significantly. Who this helps: This benefits breast cancer patients looking for information and support.

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This study examined ways to decrease the number of repeat surgeries (reoperations) that breast cancer patients undergo after their initial lumpectomy, while also ensuring that cosmetic results remain good. The conference participants, which included doctors and a patient representative, recommended several practices, including using advanced imaging techniques and better planning before and after surgery, to achieve these goals. By implementing these recommendations, the hope is to lower the reoperation rate, which varies significantly among patients. Who this helps: This helps breast cancer patients and their doctors.

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This study examined why patients often need a second surgery (re-excision) after their first breast cancer surgery (lumpectomy). Out of 6,725 patients, about 22% had to undergo re-excision, with the main reason being that cancer was still present at the edges of the removed tissue (positive margins) in almost half of the cases. Understanding these reasons helps improve surgical techniques and patient outcomes. Who this helps: This benefits breast cancer patients and their surgeons by reducing the need for additional surgeries.

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This study looked at whether it's necessary to remove all fibroepithelial lesions (FELs) in the breast to rule out a more serious condition called phyllodes tumor. Out of 313 patients studied, 83% were monitored without surgery, and only 1% were later diagnosed with a phyllodes tumor, while 35% of those who had surgery were found to actually have it. The findings show that many patients can safely avoid unnecessary surgery without risking missing a phyllodes tumor. Who this helps: This research benefits patients diagnosed with fibroepithelial lesions and helps doctors make more informed treatment decisions.

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This study looked at how often a specific biopsy method called core needle biopsy (CNB) was used to diagnose breast cancer in a specialized center between 2007 and 2008. Out of 360 new breast cancer cases, 350 (or 97%) were diagnosed using minimally invasive techniques like CNB, which helps reduce surgery and increase patient satisfaction. This high rate of effective diagnosis is important because it shows that using these advanced techniques can lead to better outcomes for patients with breast cancer. Who this helps: Patients with breast cancer benefit from less invasive diagnosis and better treatment options.

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This study looked at different types of breast imaging—mammography, ultrasound, and MRI—to see how well they agree with each other in diagnosing breast issues. The researchers found that these imaging methods are important for evaluating breast conditions, ensuring that patients get the right diagnosis and treatment. This matters because accurate imaging can lead to better outcomes for those with breast health concerns. Who this helps: Patients experiencing breast issues.

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This study looked at patients who showed up at a breast center with redness in their breast. Out of the 3,762 patients seen, only 22 had this issue, which made up about 0.6% of the total. Most of these patients were diagnosed with conditions like mastitis (32%) or breast abscesses (14%), and after treatment, 67% of them felt better. This matters because it shows that while a red breast is rare, most patients can recover with the right diagnosis and care. Who this helps: This helps patients presenting with breast redness and their doctors.

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This research examined how to effectively measure and improve the quality of care provided by breast surgeons. It highlighted that relying on certain databases to judge quality can be unfair and misleading, leading to potential penalties for surgeons. The study emphasized that breast surgeons should actively engage in quality improvement initiatives to enhance care and demonstrate their commitment to better patient outcomes. Who this helps: This benefits breast cancer patients and their surgeons.

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This study looked at how breast care centers in the U.S. measure and improve their quality of care using a program called the National Quality Measures for Breast Centers (NQMBC). Since 2005, over 200 centers have submitted data on more than 30,000 patients, allowing them to compare their performance in areas like the speed of care with similar facilities. This matters because it helps centers recognize what they're doing well and where they can improve, ensuring better care for patients over time. Who this helps: Patients receiving breast care services.

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This study looked at how quickly breast cancer patients received their diagnoses and treatments at a specialized breast center from 2004 to 2007. Researchers found that it took an average of 6 days from an abnormal mammogram to get a biopsy, and subsequent steps like surgery took 1 to 7 days, depending on the type of surgery and other choices. More than 90% of patients felt their expectations for timely service were met or exceeded, highlighting the importance of timely care in patient satisfaction. Who this helps: This helps breast cancer patients and their doctors.

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This study looked at how the quality of care during breast cancer surgery relates to its cost. It found that certain procedures, like using a needle biopsy instead of a more expensive surgical biopsy, can both lower costs and improve care quality. Other treatments, like post-mastectomy reconstruction, tend to be more expensive while also providing higher quality care. Understanding these relationships could help reduce overall costs for breast cancer treatment while maintaining or even improving the quality of care. Who this helps: Patients undergoing breast cancer treatment.

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This study looked at how many breast cancer surgeries could be done using local or regional anesthesia instead of general anesthesia. Out of 70 patients, 52 (74%) had their surgeries using these methods, with no need for general anesthesia and no unexpected overnight stays in the hospital. Additionally, only 10% of patients experienced nausea or vomiting afterward, showing that local or regional anesthesia can be effective and safe for these procedures. Who this helps: This benefits breast cancer patients who can avoid the risks of general anesthesia.

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This study examined various patient-centered quality measures related to one-step breast cancer surgeries involving sentinel lymph node biopsies. Researchers reviewed the records of 695 patients and found that 86% successfully completed their surgeries in one step, and 83% reported excellent pain control. Additionally, the rate of local cancer recurrence was low, at just 2% after an average of over three years. Who this helps: This benefits patients undergoing breast cancer surgeries by providing clear information on the quality of care they can expect.

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This study examined the quality of breast cancer care provided by a community breast center by comparing its performance against national standards. Over three years (2004-2006), the center showed impressive results: 94-96% of patients had their cancer diagnosed through needle biopsies, almost all eligible patients (91-96%) underwent a specific type of lymph node surgery, and patient involvement in treatment decisions increased significantly from 74% to 99%. These findings highlight that community centers can effectively track and improve the quality of patient care in breast cancer treatment. Who this helps: This benefits patients receiving breast cancer care and their healthcare providers.

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The study focused on a rare condition called tumoral pseudoangiomatous stromal hyperplasia (PASH) in the breast, examining how it can be identified using imaging tests before surgery. Out of 22 patients, 77% felt a lump, while 72% showed density on their mammograms. The research also found that a specific needle biopsy method could correctly identify PASH in 83% of cases, which is important because many patients with PASH show signs similar to breast cancer, leading to unnecessary surgeries. Who this helps: This helps patients with breast lumps and doctors diagnosing breast conditions.

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This study evaluated how well a breast cancer center followed national treatment guidelines for new patients in 2004. Among 200 patients, the center showed high compliance rates for most treatments, like 97% for breast surgery and lymph node surgery, but only 63% for systemic treatments. The main reasons for not following guidelines included patients choosing to skip some treatments or having limited life expectancy. Who this helps: This research benefits patients by highlighting areas for improvement in their breast cancer care.

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This study looked at complex gastrointestinal surgeries performed at a community hospital over a seven-year period. Out of 106 patients, the average hospital stay was about 13 days, with 14% experiencing major complications and a low mortality rate of 1.9%. This shows that complex surgeries can be safely performed in smaller hospitals, which is important for improving patient care when considering where surgeries are done. Who this helps: This helps patients and doctors in rural communities who need access to complex surgical procedures.

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This study looked at two patients with a rare blood condition called acquired factor VIII inhibitor coagulopathy who needed their gallbladders removed through surgery. One patient had serious bleeding after the surgery, while the other had a successful operation with the right treatments, but it still cost over $50,000. The findings highlight the importance of identifying this condition before surgery to prevent severe complications and ensure better patient outcomes. Who this helps: This helps patients with factor VIII inhibitor coagulopathy and their doctors.