NEW YORK -
Laura Lechtenberg was diagnosed with breast cancer in September at age 43. It came as a shock.
"It seemed not real; seemed like it wasn't happening. I'm... no way this is happening to me," she said.
Ten days later doctors removed the cancerous cells with a partial mastectomy. But that was just the beginning.
"A week later I had to have a second re-excision and then a week later I had to have a third surgery," Lechtenberg said.
A new study in the Journal of the American Medical Association finds her story is not unusual. Almost one in four women needs additional surgery after a partial mastectomy. Lechtenberg's doctor says it's a problem the medical community is struggling to address.
"A lot of different techniques have been applied to try to reduce that percentage further with different technology, different imaging, ways of doing surgery. Nothing, so far, universally has been able to do that," said Dr. Catherine Dang, a breast surgeon at Cedars-Sinai Medical Center.
Partial mastectomies are one of the most common cancer operations in the United States. When additional surgeries are necessary, the stress on the patient is enormous.
In a partial mastectomy, doctors remove the cancer along with a margin of normal breast tissue surrounding it. But the study found there's no clear consensus on how large that margin should be. Dr. Freya Schnabel, the director of breast cancer surgery at NYU Langone Medical Center, says at least a millimeter all around.
"Healthy tissue 360 degrees, all around the cancer to feel that we have thoroughly and completely removed the site of disease," Schnabel said.
If the tissue surgeons remove shows abnormal cells around the edge, additional surgery may be necessary. But the goal is to conserve as much of the breast as possible.
"If I could save my breast, I would do anything to save my breast," Lechtenberg said.
Lechtenberg knew the risk. Even after three surgeries, she says it was worth it.
The Food and Drug Administration is looking at a new device called a margin probe. If approved, it will be used during surgery to determine if the margins around the cancer are clean. Doctors think it could significantly reduce the number of re-operations after a partial mastectomy.
