Cavity Shaving and Breast Tumors

iStock_000020076031_MediumWhen a tumor is removed from the breast, can an approach where the surgeon removes just a bit more tissue surrounding the tumor itself result in fewer reoperations and a lower risk of recurrence, so-called 'cavity shaving'?  A study Rick and I discuss on PodMed this week, and published in the New England Journal of Medicine concludes the answer is yes, with the need for reoperation and risk for recurrence in early stage breast cancer reduced by about 50%.  That's impressive, and well worth considering when a woman has to undergo surgery to remove a breast tumor.

For whom is such an approach warranted?  Women with early stage, smaller tumors, generally speaking. David Euhus, head of breast surgery at Johns Hopkins and author of an earlier study looking at the same issue, says considerations like contour of the breast and symmetry between them also enter the picture, but even so, he advocates for breast sparing surgery for most women and lauds this study.  Other topics this week include breast cancer screening recommendations, long term follow-up in those under treatment for type 2 diabetes, and the addition of another agent to statins to reduce LDL cholesterol and outcomes, all in NEJM.  Until next week, y'all live well.

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