Posted by: Salvatore J. Zambri, founding member and partner
According to a recent article in the
New York Times, inconsistent guidelines are prevalent among radiology oncologists and
breast cancer surgeons. "Nearly half of women who had lumpectomies
for breast cancer had second operations they may not have needed because
surgeons have been unable to agree on guidelines for the most common operation
for breast cancer, a new study finds. It also hints that some women who
might benefit from further surgery may be missing out on it."
Dr. Laurence Cahill, author of the study, surgeon and assistant director
of the Lacks Cancer Center in Grand Rapids, Michigan and Dr. Monica Morrow,
chief of breast surgery at Memorial Sloan-Kettering Cancer Center in New
York, concluded that a consensus statement needs to be made by the leaders
in oncology radiation and surgery. Close to half of the repeat operations
were performed on women whose pathology reports indicated that no cancer
cells were left behind after the first surgery while 14% of the patients who
did have cancer left behind did not have a second operation. Repeat surgery
rates range from 0% to 70% and can vary widely by doctor. However, a doctor’s
repeat rate is not necessarily the best indicator of whether the original
operation was done correctly, as the surgeon may have performed more mastectomies
than lumpectomies or could have neglected to operate a second time, even
when it was needed.
After a lumpectomy, the most common operation for breast cancer, nearly
all patients receive additional radiation and systemic treatment with
chemotherapy or hormones to decrease the recurrence rate and margin size
concerns. Questions remain as to the margin necessary between cancer cells
and healthy tissue. Until those questions can be answered and surgeons
come to a consensus, many women will continue to either have a potentially
unnecessary second surgery or miss one when it is needed. Both of these
unsatisfactory options add more physical and mental stress for patients.
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About the author:
Mr. Zambri is a Board-Certified Civil Trial Attorney and Past-President of the Trial
Lawyers Association of Metropolitan Washington, D.C. The association has
recently named him the
" 2011 Trial Lawyer of the Year". He has also been acknowledged by Washingtonian magazine as a
"Big Gun" and among the "top 1%" of all of the more than 80,000 lawyers in the Washington metropolitan
area. The magazine also acknowledged him as
"one of Washington’s best–most honest and effective lawyers" who specializes in medical malpractice matters, product liability claims,
and serious automobile accident claims. Mr. Zambri was recently (2011
edition) acknowledged as one of the
"Best Lawyers in America" by
Best Lawyers, and has also been repeatedly named a
"Super Lawyer" by
Law and Politics magazine (2011)–a national publication that honors the top lawyers
in the country.
Mr. Zambri is regularly asked to present seminars to lawyers and doctors,
as well as both medical and law students concerning defective drugs, medication
errors, medical malpractice litigation, and safety improvements.
If you have any questions about your legal rights, please email Mr. Zambri at
email@example.com. You may also reach him at 202-822-1899.