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Cancer Surgery

Surgical excision is the most common way to remove benign or malignant tumors (as opposed to local  therapies such as cryotherapy, radiation therapy, or laser therapy). 

 

Surgeons have to manually remove the tumor and some nearby tissues using a scalpel.

Traditional Cancer Surgery Procedure

Step 1: Remove the Tumor and some
Surrounding Tissue

Step 2:

Postoperative Biopsy

First, the main cancerous tumor is surgically removed. After the main tumor has been removed, the surgeon will cut out a certain margin of surrounding tissue to make sure all cancer cells have been removed.

However, it's hard for surgeons to determine how much of the surrounding tissue is cancerous during surgery. 

​This means that cancer cells may remain in surrounding tissues after surgery, and this can grow into a new tumor. To prevent this, surgeons conduct a postoperative biopsy. 

Since surgeons can't tell during surgery which tissue is cancerous, they must cut a small piece of tissue from the edge and test it after the surgery to see if cancer cells still exist on the edge of the tissue removed. This is called a postoperative biopsy because it's done AFTER the operation. 

If no cancer cells are found in the biopsy, the patient is cancer-free. Oftentimes however, cancer cells remain, and the patient must undergo re-operation. Refer to the interactive image below for a visual reference. 

Interactive Image

Examine this image to understand the difference between a positive and negative post-operative biopsy result. Next, hover on the cells to learn what the implications of this are. 

No leftover cancer cells within margin = no need for reoperation 

Cancer cells leftover in margin = need for a reoperation 

The Key Issue:
Reoperation

If the post-operative biopsy result is positive, reoperation is needed. Reoperation is a second surgery done to remove cancer cells left behind from the first surgery. 

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It is also important to recognize that a reoperation is needed only because the cancerous tissue in the tissue  surrounding the main tumor wasn't identified DURING the initial surgery. Hmm... If only there way to check for this cancerous tissue during the initial surgery...

Interactive Graph

This graph emphasizes just how common reoperation is in cancer surgery. A large percentage of people who get a surgery must get a re-operation. This is a result of a failure to find the “perfect” margin that both removes cancer cells and ensures that not too much tissue is cut out. Hover over the bubbles to learn what each line represents

reop rates.jpg

What does this mean?

Percent of breast cancer patients who undergo at least one surgery.

What does this mean?

Percent of breast cancer patients who undergo reoperation

To learn about the impacts of the reoperation issue, click to the next page!

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