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This Week in JAMA
February 1, 2012

This Week in JAMA

JAMA. 2012;307(5):431. doi:10.1001/jama.2012.69

Among many women diagnosed with breast cancer, breast conservation surgery (partial mastectomy) is often the initial treatment. However, reexcision to achieve an appropriate tumor-free margin is often necessary, and variability in the reexcision rate across institutions or surgeons may reflect quality of care. In an analysis of data from 2206 women with invasive breast cancer who underwent partial mastectomy at 4 institutions between 2003 and 2008, McCahill and colleagues assessed hospital and surgeon-specific variation in reexcision rates following partial mastectomy. The authors report that 23% of the women underwent reexcision, and they found substantial surgeon and institutional variation in reexcision rates that could not be explained by patients' clinical characteristics. In an editorial, Morrow and Katz discuss quality measures for breast cancer surgery.