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Organization: Henry Mayo Newhall Memorial Hospital
Date: February 16, 2009
Study Reports Henry Mayo Physicians Achieve High-Quality Outcomes for Breast Cancer Patients
VALENCIA, CA (February 16, 2009) — Nearly two-thirds of all breast cancer patients in the United States are treated at community hospitals as opposed to larger teaching institutions. Yet few studies have ever been done comparing the care and outcomes in these settings.
Now, a seven-year study on breast-conserving surgery at Henry Mayo Newhall Memorial Hospital, appearing this month in the The Breast Journal, reports high-quality patient outcomes, comparable to large teaching institutions, can be achieved in the community setting.
"This study basically resets the bar on how to do lumpectomies and what patients can expect if it is done this way," said Henry Mayo’s Breast Center Medical Director Gregory Senofsky, MD. "Our findings are hard to ignore."
The study was conducted by a nine-person investigative team, six of whom are affiliated with Henry Mayo. Leading the study were Drs. Senofsky and Barbara Florentine. In addition to his role at Henry Mayo, Dr. Senofsky is a clinical faculty member at UCLA’s surgical oncology department and the author of The Patient’s Guide to Outstanding Breast Cancer Care. Dr. Florentine is medical director of the department of pathology and is affiliated with the department of pathology at the Keck School of Medicine at the University of Southern California. Additional Henry Mayo participants include physicians John Barstis, MD, Alexander Black, MD, and Robert Zimmerman, MD, along with Brian Cooper, tumor registrar officer.
One important objective of the study was to evaluate the adequacy of the surgical removal of the primary tumor. Florentine notes that "one of the most important factors in decreasing the risk of the local breast relapse is the successful removal of the lesion along with a surrounding rim (or "margin") of normal tissue. However, according to Florentine, "the definition of what constitutes an adequate margin varies among institutions. Many published studies consider margins as adequate when a 1-2mm rim of normal tissue is present between the tumor and the margins. We aim for a 5mm margin because we know that 1-2mm margins are not adequate to guarantee removal of the entire lesion, leaving a risk that residual tumor might be left behind in the patient. This seems to be borne out in our low local recurrence rate. Although our study size is small, our 5-year breast local recurrence rate was only 2 percent for stage I and stage II cancer which is better than the 4-9 percent data published from retrospective trials. I attribute this good outcome to a combination of good surgical technique with ancillary oncologic treatment".
The flap-advancement reconstruction surgery performed by Dr. Senofsky requires a team which includes a specially trained surgeon and radiologist plus the presence of a pathologist in the operating room to provide real-time information. "The procedure requires extra work and extra training in how radiologists insert the wires and how surgeons approach their craft relative to performing larger targeted lumpectomies with excellent cosmetic results, but it is what patients should come to expect based on our study," he says.
"It is difficult to successfully obtain adequate excision of the cancer while still maintaining a beautiful breast with no distortions — and that’s very important to a woman," stated Dr. Florentine. "Dr. Senofsky is able to achieve both through the use of oncoplastic techniques."
This study tracked 185 cases at Henry Mayo from 1997-2003. Survival rates for patients undergoing this treatment at Henry Mayo compared favorably with data presented by the National Council Database reporting on outcomes at teaching/research hospital, with a disease-free survival for early stage cancer of 91 percent.
While Henry Mayo has no comprehensive breast center building, the hospital does provide equivalent services thanks to a well-integrated medical campus and a multi-modality breast team that meets regularly to discuss care plans tailored to the uniqueness of each patient, including age, health status, risk factors, and the patient’s own desires and needs. The hospital owns and operates the pathology, breast imaging, and inpatient and outpatient surgical operating suites while on-campus radiation, medical oncology and breast surgery services are provided by independent physician groups.
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ABOUT HENRY MAYO — Henry Mayo Newhall Memorial Hospital is a 221 bed not-for-profit acute care hospital serving the Santa Clarita Valley since 1975. Services include trauma, emergency, intensive care, maternity, surgery, nursing, wound care, behavioral health, and acute rehab, as well as cancer, cardiology, imaging, lab, digestive, respiratory services and physical and occupational therapies. Henry Mayo Newhall Memorial Hospital is located at 23845 McBean Parkway, Valencia, CA 91355-2083. For more information, visit www.henrymayo.com or call 661-253-8000.
