scholarly journals Oncological impact of re-excision for positive margin status after breast conserving surgery in invasive breast cancer

2019 ◽  
Vol 30 ◽  
pp. v73-v74
Author(s):  
K. Jimbo ◽  
C. Watase ◽  
U. Nakadaira ◽  
T. Murata ◽  
S. Shiino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Positive Margin ◽  
Breast Conserving Surgery ◽  
Margin Status

Can Radiologic Tumor Size Following Neoadjuvant Therapy Reliably Guide Tissue Resection in Breast Conserving Surgery in Patients with Invasive Breast Cancer?

2020 ◽  
Vol 86 (10) ◽  
pp. 1248-1253
Author(s):  
Sarah Walcott-Sapp ◽  
Marissa K. Srour ◽  
Minna Lee ◽  
Michael Luu ◽  
Farin Amersi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Therapy ◽  
Invasive Breast Cancer ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Positive Margin ◽  
Breast Conserving Surgery ◽  
Breast Cancers ◽  
Positive Margin Rate

Optimum tissue resection volume for patients with invasive breast cancer undergoing breast conserving surgery following neoadjuvant therapy (NAT) is not known. We compared positive margin and in-breast tumor recurrence (IBTR) between 2 groups that were created based on radiologic tumor size (RTS (cm3)) at diagnosis, RTS post-NAT, and volume of tissue resected (VTL): Pre-NAT group, patients with VTL closer to RTS at diagnosis, and post-NAT group, patients with VTL closer to post-NAT RTS. 82 patients with 84 breast cancers treated with NAT between 2007 and 2017 who had pre- and post-NAT imaging were identified from a prospectively maintained database. RTS at diagnosis, RTS post-NAT, and VTL were determined. Clinical and treatment characteristics, IBTR, and disease-free survival (DFS) were compared between pre-NAT (n = 51) and post-NAT (n = 33) groups. Compared to post-NAT patients, pre-NAT patients had smaller RTS at presentation (9.2 vs. 33.5 cm3, P < .001) and post-NAT (1.2 vs. 8.2 cm3, P = .024). At median follow-up of 4 years, there were no differences between groups in pathologic tumor size, positive margin rate, adjuvant therapy, IBTR, or DFS. Resection volumes that matched RTS on post-NAT imaging were not associated with increased positive margins or IBTR. It may be appropriate to use post-NAT imaging to guide lumpectomy volume.

Does Breast Cancer Subtype Impact Margin Status in Patients Undergoing Partial Mastectomy?

2022 ◽  
pp. 000313482110697
Author(s):  
Ileana Horattas ◽  
Andrew Fenton ◽  
Joseph Gabra ◽  
Amanda Mendiola ◽  
Fanyong Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Molecular Subtype ◽  
Breast Cancer Subtype ◽  
Positive Margin ◽  
Margin Status ◽  
Partial Mastectomy ◽  
Positive Margin Rate ◽  
Cancer Subtype ◽  
The Impact

Background Molecular subtype in invasive breast cancer guides systemic therapy. It is unknown whether molecular subtype should also be considered to tailor surgical therapy. The present investigation was designed to evaluate whether breast cancer subtype impacted surgical margins in patients with invasive breast cancer stage I through III undergoing breast-conserving therapy. Methods Data from 2 randomized trials evaluating cavity shave margins (CSM) on margin status in patients undergoing partial mastectomy (PM) were used for this analysis. Patients were included if invasive carcinoma was present in the PM specimen and data for all 3 receptors (ER, PR, and HER2) were known. Patients were classified as luminal if they were ER and/or PR positive; HER2 enriched if they were ER and PR negative but HER2 positive; and TN if they were negative for all 3 receptors. The impact of subtype on the margin status was evaluated at completion of standard PM, prior to randomization to CSM versus no CSM. Non-parametric statistical analyses were performed using SPSS Version 26. Results Molecular subtype was significantly correlated with race ( P = .011), palpability ( P = .007), and grade ( P < .001). Subtype did not correlate with Hispanic ethnicity ( P = .760) or lymphovascular invasion ( P = .756). In this cohort, the overall positive margin rate was 33.7%. This did not vary based on molecular subtype (positive margin rate 33.7% for patients with luminal tumors vs 36.4% for those with TN tumors, P = .425). Discussion Molecular subtype does not predict margin status. Therefore, molecular subtype should not, independent of other factors, influence surgical decision-making.

The significance of margin status in patients with DCIS undergoing breast-conserving surgery.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 98-98
Author(s):  
Rachel Gentile ◽  
Adam D. Currey ◽  
Jared Forrester ◽  
Bonifride Tuyishimire ◽  
Jonathan Lin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Proportional Hazards Model ◽  
Ductal Carcinoma ◽  
Positive Margin ◽  
Breast Conserving Surgery ◽  
Margin Status ◽  
Cox Proportional Hazards Model ◽  
The Impact

98 Background: Recently, SSO/ASTRO published a consensus statement on margins for stage I and II invasive breast cancer treated with breast conserving surgery (BCS). We examined patients with ductal carcinoma in situ (DCIS) who underwent BCS to determine the effect of clinicopathologic and treatment factors including margin status, on locoregional recurrence (LRR), breast cancer-specific (BCSS) and overall survival (OS). Methods: From 2003-2010, we conducted a retrospective chart review of 253 consecutively diagnosed patients who underwent BCS for DCIS. Clincopathologic and treatment data were extracted. Margin status was defined by pathology reports with a negative margin as ≥ 2mm, close margin < 2mm and positive margin as tumor on ink. Clinicopathologic variables were tested using the Fisher’s exact test, Chi-square test, ANOVA F-test, and Kruskal-Wallis test. A Cox proportional - Hazards model was used to calculate the impact of these factors on LRR, BCSS and OS. Results: The median age of the cohort was 57 (range 21-89) and the majority were white (79%), ER+ (78%) and underwent radiation therapy (67%). Forty six percent took anti-endocrine therapy. Of 252 patients, 29% had close margins, 63% had negative margins and 7% had unknown margins. One patient had a positive margin and was alive without disease at last follow-up. At a median follow-up of 5 years, OS was 96%. Thirteen patients experienced a LRR with a median time to recurrence of 4.9 years (5 with close margins, 7 with negative, 1 unknown). On multivariate analysis, age and PR status were significant predictors of LRR. Patients with age >70 were more likely to recur than those age 50-69 (HR 6.7 95% CI (1.7-25.4) p= 0.005) as were patients with PR negative tumors (HR 5.7 95% CI (1.7-19.5) p= 0.005). Those patients who did not receive radiation therapy had a worse OS than those who did (HR 4.3 95%CI (1.5-12.6) p = 0.007). No variables were significant for BCSS. Conclusions: In this cohort of patients with DCIS treated with BCS, age and PR status were the only predictors of LRR. OS was only impacted by receipt of radiotherapy. Margin status was not predictive of LRR, BCSS or OS. This data suggests that routine re-excision for close margins may not be warranted.

Sequence of radiotherapy and chemotherapy after breast-conserving surgery in small invasive breast cancer

2000 ◽  
Vol 48 (3) ◽  
pp. 291-292 ◽  
Author(s):  
R Dendale ◽  
E Mouret-Foyrme ◽  
F Campana ◽  
A de la Rochefordière ◽  
J.R Vilcoq ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Breast Conserving Surgery

scholarly journals Re-Excision Rates in Breast-Conserving Surgery for Invasive Breast Cancer after Neoadjuvant Chemotherapy with and without the Use of a Radiopaque Tissue Transfer and X-ray System

Breast Care ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 302-307
Author(s):  
Suniza Jamaris ◽  
Leyla Akpolat-Basci ◽  
Miltiades Stephanou ◽  
Sarah Wetzig ◽  
Yueksel Cubuk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Invasive Breast Cancer ◽  
Breast Conserving Surgery ◽  
Control Group ◽  
Study Group ◽  
Transfer System ◽  
Tissue Transfer ◽  
Resected Tissue ◽  
Specimen Radiography

Background: Significant re-excision rates in breast-conserving surgery (BCS) after neoadjuvant systemic chemotherapy may result from difficulties in defining the surgical target particularly in cases with excellent treatment response. Devices allowing an exact topographic localisation of the lesion in the resected tissue could reduce re-excision rates by optimising the intraoperative detection of involved margins. Methods: 80 patients with invasive breast cancer receiving BCS after neoadjuvant chemotherapy were included in this non-randomized case-control study. 40 patients with specimen radiography performed in a standard approach (control group) were compared to 40 patients with use of a radiopaque tissue transfer system (study group). Results: 19/80 (23.75%) patients required re-excision because of involved margins; among those, 14/40 (35%) were in the control group and 5/40 (12.5%) in the study group. The association between the use of the radiopaque tissue transfer system and the lower re-excision rate was statistically significant (p = 0.023). Conclusion: Our analysis provides a rationale for the routine use of a radiopaque tissue transfer system for specimen radiography in BCS after neoadjuvant chemotherapy for invasive breast cancer in order to reduce re-excision rates.

scholarly journals The clinical impact of molecular breast imaging in women with proven invasive breast cancer scheduled for breast-conserving surgery

2018 ◽  
Vol 169 (3) ◽  
pp. 513-522 ◽  
Author(s):  
Angela Collarino ◽  
Renato A. Valdés Olmos ◽  
Lotta G. A. J. van Berkel ◽  
Peter A. Neijenhuis ◽  
Lidy M. H. Wijers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Breast Imaging ◽  
Breast Conserving Surgery ◽  
Clinical Impact ◽  
Molecular Breast Imaging
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