What is Re-Excision?
Re-excision refers to a surgical procedure performed to remove additional tissue after an initial
surgery. This is often necessitated when the margins of the original surgical excision show the presence of
cancer cells, indicating that not all of the malignant tissue was removed.
When is Re-Excision Necessary?
Re-excision is typically required when the pathology report from the initial surgery reveals
positive margins. Positive margins mean that cancerous cells are present at the edge of the removed tissue, suggesting that some part of the tumor may still be in the body. This is a crucial step to ensure that no residual cancer remains, which could lead to a
recurrence.
Types of Cancers Requiring Re-Excision
Re-excision is most commonly associated with
breast cancer, but it can be applicable to other types of cancer as well, such as
skin cancer (melanoma),
colorectal cancer, and
head and neck cancers. The necessity for re-excision can depend on the type of cancer, its location, and the surgical margins obtained during the initial surgery.
How is Re-Excision Performed?
The surgical procedure for re-excision is similar to the initial excision. The surgeon will make an incision to remove additional tissue around the area where the cancer was initially found. The goal is to achieve clear margins, meaning no cancer cells are found at the edges of the removed tissue. This may involve more precise techniques and sometimes the use of
imaging techniques to guide the surgery.
Risks and Complications
Like any surgical procedure, re-excision carries risks and potential complications. These can include
infection,
bleeding, and
anesthesia-related issues. Additionally, re-excision can impact aesthetics and functionality, particularly in cases like breast cancer, where additional tissue removal can affect the shape and size of the breast.
Post-Surgery Considerations
After a re-excision, patients usually require follow-up appointments to monitor healing and to check for any signs of recurrence.
Adjuvant therapies such as
radiation or
chemotherapy may also be recommended to eliminate any remaining cancer cells and reduce the risk of recurrence.
Impact on Prognosis
Achieving clear margins through re-excision can significantly improve the
prognosis for cancer patients. It reduces the likelihood of local recurrence and can enhance overall survival rates. However, the impact on prognosis can vary based on the type of cancer, the stage at which it was detected, and the patient's overall health.
Patient Support and Counseling
Undergoing re-excision can be a challenging experience for patients, both physically and emotionally. It is crucial for healthcare providers to offer comprehensive
support and counseling to address any concerns and to provide information about the procedure, recovery, and follow-up care.
Conclusion
Re-excision is an important surgical step in the treatment of various cancers to ensure complete removal of malignant cells. While it carries certain risks, its benefits in achieving clear margins and improving patient outcomes make it a vital component of
cancer treatment.
