{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T09:02:23Z","timestamp":1784538143817,"version":"3.55.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Today"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Partial mastectomy for breast cancer may be followed by unplanned secondary surgery due to adverse outcomes, such as the detection of positive margins or cancer recurrence, thus adding burden to patients, providers, and payers. We analyzed the prevalence of this outcome and its economic impact in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We utilized the Medical Data Vision (MDV) Research Database to identify a cohort of women in Japan who underwent an index partial mastectomy between 2008 and 2023, following their healthcare encounters up to 5 years postoperatively, including any secondary partial or total mastectomies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 49,659 patients with breast cancer underwent primary partial mastectomy, and 2,203 (4.4%) underwent a second surgery. Among these secondary procedures, approximately two-thirds were total mastectomies. The median five-year postoperative healthcare expenditure among patients with one primary partial mastectomy was \u00a51.8\u00a0million, and \u00a52.5\u00a0million among patients requiring more than one procedure. Secondary procedures were more common among younger patients, those with larger tumors, and those who did not receive neoadjuvant therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Partial mastectomy is an essential surgical treatment for early stage breast cancer in Japan. While secondary surgery rates are low compared with other countries, these procedures still have negative financial consequences and extend patients\u2019 journeys to remission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00595-026-03429-3","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:07:22Z","timestamp":1784534842000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary breast surgery after initial partial mastectomy for breast cancer in Japan"],"prefix":"10.1007","author":[{"given":"Munetsugu","family":"Hirata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Kijima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam E.","family":"Wing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-Lin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisamitsu","family":"Zaha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"3429_CR1","unstructured":"Globocan. 2022. International Agency for Research on Cancer;2024."},{"issue":"10","key":"3429_CR2","doi-asserted-by":"publisher","first-page":"420","DOI":"10.2188\/jea.JE20170103","volume":"28","author":"A Yoshimura","year":"2018","unstructured":"Yoshimura A, Ito H, Nishino Y, et al. Recent Improvement in the Long-term Survival of Breast Cancer Patients by Age and Stage in Japan. J Epidemiol. 2018;28(10):420\u20137.","journal-title":"J Epidemiol"},{"issue":"4","key":"3429_CR3","doi-asserted-by":"publisher","first-page":"5748","DOI":"10.18632\/aging.202502","volume":"13","author":"J Huang","year":"2021","unstructured":"Huang J, Chan PS, Lok V, et al. Global incidence and mortality of breast cancer: a trend analysis. Aging. 2021;13(4):5748\u2013803.","journal-title":"Aging"},{"key":"3429_CR4","unstructured":"Comprehensive Survey of Living Conditions. Ministry of Health, Labour and Welfare, Japan; 2019. https:\/\/www.mhlw.go.jp\/toukei\/saikin\/hw\/k-tyosa\/k-tyosa19\/index.html. Accessed May 6, 2026."},{"key":"3429_CR5","unstructured":"OECD Data Explorer, Screening. https:\/\/data-explorer.oecd.org\/. Published 2024. Accessed May 6, 2026."},{"issue":"6","key":"3429_CR6","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","volume":"68","author":"F Bray","year":"2018","unstructured":"Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin. 2018;68(6):394\u2013424.","journal-title":"Cancer J Clin"},{"key":"3429_CR7","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s12282-014-0558-7","volume":"22","author":"Y Komoike","year":"2015","unstructured":"Komoike Y, Inokuchi M, Itoh T, et al. Japan Breast Cancer Society clinical practice guideline for surgical treatment of breast cancer. Breast Cancer. 2015;22:37\u201348.","journal-title":"Breast Cancer"},{"issue":"3","key":"3429_CR8","first-page":"303","volume":"122","author":"Y Kijima","year":"2021","unstructured":"Kijima Y. Trends in Breast Surgery. J Japan Surg Soc. 2021;122(3):303\u20136.","journal-title":"J Japan Surg Soc"},{"issue":"7","key":"3429_CR9","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1001\/jamasurg.2021.1438","volume":"156","author":"J de Boniface","year":"2021","unstructured":"de Boniface J, Szulkin R, Johansson ALV. Survival After Breast Conservation vs Mastectomy Adjusted for Comorbidity and Socioeconomic Status: A Swedish National 6-Year Follow-up of 48 986 Women. JAMA Surg. 2021;156(7):628\u201337.","journal-title":"JAMA Surg"},{"issue":"12","key":"3429_CR10","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1001\/jamasurg.2014.926","volume":"149","author":"LG Wilke","year":"2014","unstructured":"Wilke LG, Czechura T, Wang C, et al. Repeat Surgery After Breast Conservation for the Treatment of Stage 0 to II Breast Carcinoma: A Report From the National Cancer Data Base, 2004\u20132010. JAMA Surg. 2014;149(12):1296\u2013305.","journal-title":"JAMA Surg"},{"key":"3429_CR11","doi-asserted-by":"publisher","first-page":"e4505","DOI":"10.1136\/bmj.e4505","volume":"345","author":"R Jeevan","year":"2012","unstructured":"Jeevan R, Cromwell DA, Trivella M, et al. Reoperation rates after breast conserving surgery for breast cancer among women in England: retrospective study of hospital episode statistics. BMJ. 2012;345:e4505.","journal-title":"BMJ"},{"issue":"10","key":"3429_CR12","doi-asserted-by":"publisher","first-page":"3185","DOI":"10.1245\/s10434-014-3905-1","volume":"21","author":"J Landercasper","year":"2014","unstructured":"Landercasper J, Whitacre E, Degnim AC, Al-Hamadani M. Reasons for re-excision after lumpectomy for breast cancer: insight from the American Society of Breast Surgeons Mastery(SM) database. Ann Surg Oncol. 2014;21(10):3185\u201391.","journal-title":"Ann Surg Oncol"},{"issue":"5","key":"3429_CR13","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1001\/jama.2012.43","volume":"307","author":"LE McCahill","year":"2012","unstructured":"McCahill LE, Single RM, Aiello Bowles EJ, et al. Variability in reexcision following breast conservation surgery. JAMA. 2012;307(5):467\u201375.","journal-title":"JAMA"},{"issue":"3","key":"3429_CR14","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.ijrobp.2013.11.012","volume":"88","author":"MS Moran","year":"2014","unstructured":"Moran MS, Schnitt SJ, Giuliano AE, et al. Society of Surgical Oncology-American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. Int J Radiat Oncol Biol Phys. 2014;88(3):553\u201364.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"5","key":"3429_CR15","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1245\/s10434-019-07247-5","volume":"26","author":"L Havel","year":"2019","unstructured":"Havel L, Naik H, Ramirez L, Morrow M, Landercasper J. Impact of the SSO-ASTRO Margin Guideline on Rates of Re-excision After Lumpectomy for Breast Cancer: A Meta-analysis. Ann Surg Oncol. 2019;26(5):1238\u201344.","journal-title":"Ann Surg Oncol"},{"issue":"5","key":"3429_CR16","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1016\/j.amjsurg.2019.01.007","volume":"217","author":"A Monaghan","year":"2019","unstructured":"Monaghan A, Chapinal N, Hughes L, Baliski C. Impact of SSO-ASTRO margin guidelines on reoperation rates following breast-conserving surgery. Am J Surg. 2019;217(5):862\u20137.","journal-title":"Am J Surg"},{"issue":"1","key":"3429_CR17","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s12913-018-2882-7","volume":"18","author":"S Fisher","year":"2018","unstructured":"Fisher S, Yasui Y, Dabbs K, Winget M. Re-excision and survival following breast conserving surgery in early stage breast cancer patients: a population-based study. BMC Health Serv Res. 2018;18(1):94.","journal-title":"BMC Health Serv Res"},{"issue":"9","key":"3429_CR18","doi-asserted-by":"publisher","first-page":"5341","DOI":"10.1245\/s10434-023-13592-3","volume":"30","author":"R Matar-Ujvary","year":"2023","unstructured":"Matar-Ujvary R, Haglich K, Flanagan MR, et al. The impact of breast-conserving surgery re-excision on patient-reported outcomes using the BREAST-Q. Ann Surg Oncol. 2023;30(9):5341\u20139.","journal-title":"Ann Surg Oncol"},{"issue":"10","key":"3429_CR19","doi-asserted-by":"publisher","first-page":"6288","DOI":"10.1245\/s10434-022-12127-6","volume":"29","author":"JM Chakedis","year":"2022","unstructured":"Chakedis JM, Tang A, Savitz A, et al. Economic impact of reducing reexcision rates after breast-conserving surgery in a large, integrated health system. Ann Surg Oncol. 2022;29(10):6288\u201396.","journal-title":"Ann Surg Oncol"},{"issue":"3","key":"3429_CR20","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s10549-025-07735-1","volume":"212","author":"SE Wing","year":"2025","unstructured":"Wing SE, Liu Y, Zheng F, Hamm NC, Dekhne NS, Selber JC. Insurer and patient costs for repeat breast surgery after initial lumpectomy for breast cancer. Breast Cancer Res Treat. 2025;212(3):457\u201365.","journal-title":"Breast Cancer Res Treat"},{"issue":"2","key":"3429_CR21","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s40801-022-00296-5","volume":"9","author":"T Laurent","year":"2022","unstructured":"Laurent T, Simeone J, Kuwatsuru R, et al. Context and considerations for use of two Japanese real-world databases in Japan: Medical Data Vision and Japanese Medical Data Center. Drugs Real World Outcomes. 2022;9(2):175\u201387.","journal-title":"Drugs Real World Outcomes"},{"issue":"5","key":"3429_CR22","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","volume":"40","author":"ME Charlson","year":"1987","unstructured":"Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373\u201383.","journal-title":"J Chronic Dis"},{"issue":"6","key":"3429_CR23","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1080\/03610910902859574","volume":"38","author":"PC Austin","year":"2009","unstructured":"Austin PC. Using the Standardized Difference to Compare the Prevalence of a Binary Variable Between Two Groups in Observational Research. Commun Stat - Simul Comput. 2009;38(6):1228\u201334.","journal-title":"Commun Stat - Simul Comput"},{"issue":"1","key":"3429_CR24","first-page":"250","volume":"188","author":"F Li","year":"2019","unstructured":"Li F, Thomas LE, Li F. Addressing extreme propensity scores via the overlap weights. Am J Epidemiol. 2019;188(1):250\u20137.","journal-title":"Am J Epidemiol"},{"key":"3429_CR25","unstructured":"Greifer N. WeightIt: Weighting for Covariate Balance in Observational Studies. R package version 1.5.0. https:\/\/ngreifer.github.io\/WeightIt\/. 2025."},{"key":"3429_CR26","unstructured":"World Bank. Consumer price index (2010\u2009=\u2009100) - Japan. https:\/\/data.worldbank.org\/indicator\/FP.CPI.TOTL?end=2024&locations=JP&start=1960&view=chart. Accessed December 30, 2025."},{"key":"3429_CR27","unstructured":"Anonymously Processed Information. Medical Data Vision Co., Ltd. https:\/\/en.mdv.co.jp\/anonymously-processed-information\/. Accessed."},{"key":"3429_CR28","unstructured":"Position statement on breast cancer lumpectomy margins. The American Society of Breast Surgeons;2013."},{"issue":"1","key":"3429_CR29","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1002\/ags3.12047","volume":"2","author":"T Shinagawa","year":"2017","unstructured":"Shinagawa T, Tanaka T, Nozawa H, et al. Comparison of the guidelines for colorectal cancer in Japan, the USA and Europe. Ann Gastroenterol Surg. 2017;2(1):6\u201312. PMID: 29863118; PMCID: PMC5881304.","journal-title":"Ann Gastroenterol Surg"},{"issue":"1","key":"3429_CR30","doi-asserted-by":"publisher","first-page":"79","DOI":"10.3978\/j.issn.2078-6891.2014.097","volume":"6","author":"M Yamamoto","year":"2015","unstructured":"Yamamoto M, Rashid OM, Wong J. Surgical management of gastric cancer: the East vs. West perspective. J Gastrointest Oncol. 2015;6(1):79\u201388. https:\/\/doi.org\/10.3978\/j.issn.2078-6891.2014.097 . PMID: 25642341; PMCID: PMC4294827.","journal-title":"J Gastrointest Oncol"},{"issue":"3","key":"3429_CR31","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s12282-016-0675-6","volume":"23","author":"R Horii","year":"2015","unstructured":"Horii R, Honma N, Ogiya A, et al. The Japanese Breast Cancer Society clinical practice guidelines for pathological diagnosis of breast cancer, 2015 edition. Breast Cancer (Auckl). 2015;23(3):391\u20139. https:\/\/doi.org\/10.1007\/s12282-016-0675-6.","journal-title":"Breast Cancer (Auckl)"},{"key":"3429_CR32","unstructured":"American Society of Breast Surgeons. Consensus Guideline on Breast Conservation Surgery Margins for Invasive Breast Cancer. 2024. https:\/\/www.breastsurgeons.org\/docs\/statements\/asbrs-breast-conservation-surgery-margins.pdf. Accessed December 30, 2025."},{"key":"3429_CR33","unstructured":": ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Early breast cancer, Loibl S, Andre F, Bachelot T et al. Ann Oncol, 35, Issue 2, 159\u201382."},{"key":"3429_CR34","doi-asserted-by":"publisher","DOI":"10.1007\/s12282-025-01798-0","author":"Y Horimoto","year":"2025","unstructured":"Horimoto Y, Kaise H, Ishikawa T, et al. Current practices and challenges in margin evaluation for breast-conserving surgery specimens: a nationwide survey in Japan with international benchmarking. Breast Cancer. 2025. https:\/\/doi.org\/10.1007\/s12282-025-01798-0.","journal-title":"Breast Cancer"},{"key":"3429_CR35","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2022.101779","volume":"42","author":"AYY Mohamedahmed","year":"2022","unstructured":"Mohamedahmed AYY, Zaman S, Zafar S, Laroiya I, Iqbal J, Tan MLH, et al. Comparison of surgical and oncological outcomes between oncoplastic breast-conserving surgery versus conventional breast-conserving surgery for treatment of breast cancer: a systematic review and meta-analysis of 31 studies. Surg Oncol. 2022;42:101779. https:\/\/doi.org\/10.1016\/j.suronc.2022.101779.","journal-title":"Surg Oncol"},{"key":"3429_CR36","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s12282-019-01025-7","volume":"27","author":"T Uematsu","year":"2020","unstructured":"Uematsu T, Nakashima K, Kikuchi M, et al. The Japanese Breast Cancer Society Clinical Practice Guidelines for Breast Cancer Screening and Diagnosis, 2018 Edition. Breast Cancer. 2020;27:17\u201324. https:\/\/doi.org\/10.1007\/s12282-019-01025-7.","journal-title":"Breast Cancer"},{"key":"3429_CR37","unstructured":"American Society of Breast Surgeons. Consensus Statement on Breast MRI. 2017. https:\/\/www.breastsurgeons.org\/docs\/statements\/asbrs-mri.pdf. Accessed December 30, 2025."},{"issue":"1","key":"3429_CR38","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/s00595-023-02697-7","volume":"54","author":"H Takami","year":"2024","unstructured":"Takami H, Kodera Y, Eguchi H, et al. The shortage of surgeons in Japan: Results of an online survey of qualified teaching hospitals that take part in the surgical training programs for board certification by the Japan Surgical Society. Surg Today. 2024;54(1):41\u201352.","journal-title":"Surg Today"}],"container-title":["Surgery Today"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00595-026-03429-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00595-026-03429-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00595-026-03429-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:07:26Z","timestamp":1784534846000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00595-026-03429-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":38,"alternative-id":["3429"],"URL":"https:\/\/doi.org\/10.1007\/s00595-026-03429-3","relation":{},"ISSN":["0941-1291","1436-2813"],"issn-type":[{"value":"0941-1291","type":"print"},{"value":"1436-2813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]},"assertion":[{"value":"30 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}