Metric Category: Appropriateness
The percentage of patients who underwent a re-excision within 12 months after the initial breast-conserving therapy (i.e. partial mastectomy or “lumpectomy”).
Although a breast re-excision after breast conserving surgical therapy (i.e. partial mastectomy or “lumpectomy”).is an established practice in the setting of positive margins, over-use of re-excision is associated with increased healthcare costs and a greater risk of a postoperative complication, an inferior cosmetic result, added emotional distress, and an unnecessary delay to adjuvant chemotherapy. It is important to minimize re-excision risk when it does not compromise patient safety or adequacy of tumor margin status. .
Applicable to EHR Data?
Requires Pharmacy Data?
The number of patients from the denominator who underwent a re-excision (CPT codes: 19120, 19125, 19126, 19301, 19302, 19303, 19304, 19305, 19306, 19307) performed by the same physician within 12 months after the initial breast-conserving therapy.
The number of patients who underwent an initial breast-conserving therapy (CPT codes: 19120, 19125, 19126, 19301, 19302) performed by a given physician.
All patients aged 18 years or older who underwent an initial breast conserving therapy during the study period.
|Minimal number of patients required in the denominator||Clinical threshold of what constitutes an outlier|
1. 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.
2. Landercasper J, Bennie B, Ahmad HF, et al. Opportunities to reduce reoperations and to improve inter-facility profiling after initial breast-conserving surgery for cancer. A report from the NCDB. Eur J Surg Oncol 2019;45:2026-36. 10.1016/j.ejso.2019.07.002