More People Are Keeping Their Breast After Cancer Surgery. Here's How

New surgical approaches are allowing more people with breast cancer to keep their breast. Other advances are improving the chances that surgeons remove the entire tumor in the first operation, according to Dr. Maureen P. McEvoy, breast surgeon at Montefiore Einstein Comprehensive Cancer Center and associate professor at Albert Einstein College of Medicine.

In an interview with CURE, McEvoy explained how these changes are shaping outcomes and quality of life.

Can people with larger tumors still have breast-conserving surgery?

Breast conservation has become a growing priority, McEvoy said. In the past, surgeons used a tumor size cutoff to decide who could keep their breast. That is no longer the case.

"Now, for someone with a larger tumor who still wants breast conservation, I can go in and remove the cancer, and a plastic surgeon would be there during the same surgery to help rearrange your own tissue to rebuild the breast, sort of like doing a breast reduction or a breast lift," she said.

How does saving the breast affect patient satisfaction?

A study at Montefiore compared people who had this procedure with those who had their breast removed and then had reconstruction, such as with an implant. Using a patient-reported outcomes database, researchers found that people whose breast was saved and rebuilt with their own tissue had higher satisfaction scores.

"Listening to our patients has allowed us to change the way we approach these conversations," McEvoy said. She noted that many advances in the field focus on what patients want and on better cosmetic outcomes, as long as treatment remains oncologically safe.

How can surgeons reduce the need for a second operation?

There is about a 20% to 30% risk of needing another surgery when margins are positive, meaning the first operation did not clear all the cancer, McEvoy explained.

Montefiore plans to use a device called Lumicell, which makes cancer cells light up so surgeons can detect them in the operating room.

"This will decrease the risk of having to come back for additional surgery and greatly increases the chances of getting the tumor out the first time," she said.

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