Reoperation Rates for Breast Conservation Surgery | KK Women's and Children's Hospital

At KK Breast Centre, we understand and recognise the special needs women have when it comes to selecting and receiving expert consultations and treatments for any type of breast disease, cancerous and non-cancerous.

We are an integrated centre fully dedicated to looking after breast health. First in Singapore to house a state-of-the-art breast imaging centre, this set-up enables women to have their digital mammography, breast ultrasonography, surgical consultation, minimally invasive biopsies and procedures all under one roof, and with quick turnaround time. The full range of minimally invasive breast biopsy services available include mammogram, ultrasound and MRI guided biopsy.

The centre is staffed by a multi-disciplinary team of breast surgeons, radiologists, reconstructive surgeons, medical and radiation oncologists together with pathologists, physiotherapists, medical social workers and breast care nurses.

Breast conserving surgery for breast cancer is the removal of the part of the breast which is involved by cancer with a rim of surrounding normal tissue and conservation of the remaining breast.

In some cases, breast conserving surgery may result in incomplete excision of the cancer because the actual cancer size may be greater than what was seen on preoperative imaging. This then necessitates reoperation to achieve adequate cancer clearance. Reoperation, apart from subjecting the patient to further surgical and anaesthetic risks, can also be mentally distressing to the patient. Thus, it is important to keep the reoperation rate as low as possible.

Reoperation rates vary widely between different institutions worldwide, ranging from 19-54%^1-5 but it should be kept generally below 20% as per guidelines. KK Breast Department has achieved an overall reoperation rate of 11% between the years 2020 to 2024 by using various measures such as oncoplastic surgery, accurate localisation of the cancer etc.

KK Breast Department Re-operation Rates After Breast Conserving Surgery

Year	No. of Breast conserving surgery	Re-operation surgery	% requiring re-operation
2020	88	9	10%
2021	93	10	11%
2022	109	13	12%
2023	125	13	10%
2024	125	17	14%
2020-2024	540	62	11%

Using advances in surgical and imaging techniques, KK Breast Department has achieved an overall low reoperation rate of 11% over the last 4 years, with the reoperation rates comparing favourably to those reported in large centres worldwide.

References:

Chuwa EW, Tan VH, Tan PH, Yong WS, Ho GH, Wong CY. Treatment for ductal carcinoma in situ in an Asian population: outcome and prognostic factors. ANZ J Surg. 2008 Jan-Feb;78(1-2):42-8. doi: 10.1111/j.1445-2197.2007.04354.x. PMID: 18199204.
Ramanah R, Pivot X, Sautiere JL, Maillet R, Riethmuller D. Predictors of re-excision for positive or close margins in breast-conservation therapy for pT1 tumors. Am J Surg. 2008 Jun;195(6):770-4. doi: 10.1016/j.amjsurg.2007.05.052. Epub 2008 Apr 3. PMID: 18394582.
Sabel MS, Rogers K, Griffith K, Jagsi R, Kleer CG, Diehl KA, Breslin TM, Cimmino VM, Chang AE, Newman LA. Residual disease after re-excision lumpectomy for close margins. J Surg Oncol. 2009 Feb 1;99(2):99-103. doi: 10.1002/jso.21215. PMID: 19065638.
Jeevan R, Cromwell DA, Trivella M, Lawrence G, Kearins O, Pereira J, Sheppard C, Caddy CM, van der Meulen JH. Reoperation rates after breast conserving surgery for breast cancer among women in England: retrospective study of hospital episode statistics. BMJ. 2012 Jul 12;345:e4505. doi: 10.1136/bmj.e4505. PMID: 22791786; PMCID: PMC3395735.
Kaczmarski K, Wang P, Gilmore R, Overton HN, Euhus DM, Jacobs LK, Habibi M, Camp M, Weiss MJ, Makary MA. Surgeon Re-Excision Rates after Breast-Conserving Surgery: A Measure of Low-Value Care. J Am Coll Surg. 2019 Apr;228(4):504-512.e2. doi: 10.1016/j.jamcollsurg.2018.12.043. Epub 2019 Jan 29. PMID: 30703538.