Fluorescence and Reflectance Spectroscopy and Spectral Imaging for Evaluating Surgical Margin Status during Breast Cancer Resection

PURPOSE: To examine the relationship between pathologic margin status and outcome at 8 years after breast-conserving surgery and radiation therapy. PATIENTS AND METHODS: The study population comprised 533 patients with International Union Against Cancer/American Joint Committee on Cancer clinical stage I or II breast cancer who had assessable margins, who received at least 60 Gy to the primary tumor bed, and who had more than 8 years of potential follow-up. Each margin was scored (according to the presence of invasive or in situ disease that touched the inked surgical margin) as one of the following: negative, close, focally positive, or extensively positive. Outcome at 8 years was calculated using crude rates of first site of failure. A polychotomous logistic regression analysis was performed. Median follow-up time was 127 months. RESULTS: At 8 years, patients with close margins and those with negative margins both had a rate of local recurrence (LR) of 7%. Patients with extensively positive margins had an LR rate of 27%, whereas patients with focally positive margins had an intermediate rate of LR of 14%. In the polychotomous logistic regression model, margin status and the use of systemic therapy were the only two variables that had significant effects on the risk ratio of LR to remaining alive and free of disease. Among the 45 patients with focally positive margins who received systemic therapy, the crude LR rate was 7% at 8 years (95% confidence interval, 1% to 20%). CONCLUSION: Pathologic margin status and the use of adjuvant systemic therapy are the most important factors associated with LR among patients treated with breast-conserving surgery and radiation therapy.

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The Analysis of Preoperative Wire Localization in Breast Conserving Surgery and Predictors of Surgical Margin Status

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.10.12771 ◽

2021 ◽

Vol 104 (10) ◽

pp. 1617-1625

Keyword(s):

Breast Cancer ◽

Early Stage ◽

Tumor Resection ◽

Surgical Margin ◽

Breast Conserving Surgery ◽

Margin Status ◽

Positive Surgical Margin ◽

Architectural Distortion ◽

Wire Localization ◽

Large Tumor

Background: At present, the breast conserving therapy (BCT) is considered a treatment of choice for early-stage breast cancer. BCT aims to achieve complete tumor resection with adequate margin and offers better cosmetic outcome. Objective: To describe the experience with preoperative wire localization technique for early breast cancer and analysis of factors affecting positive margin status. Materials and Methods: The authors retrospectively reviewed 190 patients with 206 malignant breast lesions treated by breast conserving surgery (BCS) after mammographic- or ultrasound- guided wire localization. Patient age, lesion type such as mass, mass with calcifications, calcifications alone, and architectural distortion, BI-RADS assessment categories, size, location, modalities of imaging guidance, number of wires used, radiological and surgical margin status, pathological diagnosis, and tumor focality were recorded. Results: A 14.56% of positive surgical margin rate was observed. Mixed-effects logistic regression analysis showed larger lesion size was a significant predictor for positive surgical margin status at larger than 1.5 cm versus 1.0 cm or smaller (p=0.033). Conclusion: The present study data suggested that larger tumor size is the only significant predictor for positive surgical margin status. To deal with non-palpable large tumor, surgeon and radiologist should pay particular attention to achieve adequate surgical margin. Keywords: Wire localization; Breast conserving surgery; Surgical margin status; Specimen radiography

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Association of Clinical and Pathologic Variables with Lumpectomy Surgical Margin Status after Preoperative Diagnosis or Excisional Biopsy of Invasive Breast Cancer

Annals of Surgical Oncology ◽

10.1245/s10434-006-9308-1 ◽

2007 ◽

Vol 14 (3) ◽

pp. 1040-1044 ◽

Cited By ~ 80

Author(s):

Melanie C. Smitt ◽

Kate Horst

Keyword(s):

Breast Cancer ◽

Invasive Breast Cancer ◽

Preoperative Diagnosis ◽

Surgical Margin ◽

Excisional Biopsy ◽

Margin Status

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Association of Clinical and Pathologic Variables with Lumpectomy Surgical Margin Status after Preoperative Diagnosis or Excisional Biopsy of Invasive Breast Cancer

Breast Diseases A Year Book Quarterly ◽

10.1016/s1043-321x(08)80044-6 ◽

2008 ◽

Vol 19 (1) ◽

pp. 67-68

Author(s):

K.L. Bland ◽

R. Henry-Tillman

Keyword(s):

Breast Cancer ◽

Invasive Breast Cancer ◽

Preoperative Diagnosis ◽

Surgical Margin ◽

Excisional Biopsy ◽

Margin Status

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“Unplanned breast-conserving surgery after systemic therapy in locally advanced breast cancer: the results of level II oncoplastic techniques”

10.22541/au.161306090.04340289/v1 ◽

2021 ◽

Author(s):

mehmet gulcelik ◽

Lütfi Doğan

Keyword(s):

Breast Cancer ◽

Primary Tumor ◽

Locally Advanced ◽

Surgical Margin ◽

Breast Conserving Surgery ◽

Margin Status ◽

Axillary Recurrence ◽

Free Survival ◽

Level Ii ◽

Significant Difference

BACKGROUND: In patients with breast cancer for whom neoadjuvant chemotherapy (NAC) is planned, it is recommended to mark the primary tumor before treatment (planned surgery). However, surgeons may have to perform breast-conserving surgery on patients whose tumors are not marked (unplanned surgery). This study focused on the results obtained with planned and unplanned level II oncoplastic surgery (OPS) techniques applied to patients after NAC. METHODS: Patient groups who underwent planned, unplanned OPS and mastectomy after NAC were compared. Surgical margin status, re-operation and re-excision requirements, ipsilateral breast tumor recurrence (IBTR) and axillary recurrence rates recorded. Long-term local recurrence-free survival (LRFS), disease-free survival and overall survival were evaluated. RESULTS: There was no significant difference between the planned and unplanned OPS groups in terms of surgical margin status, re-excision requirement, and mastectomy rates. During an average follow-up period of 43 months, 5.3% and 4% of the patients in the planned OPS group developed IBTR and axillary recurrence, respectively, whereas these rates were 6.6% and 5.3% in the unplanned OPS group. In the mastectomy group, the rates of IBTR and axillary recurrence were found to be 4.1% and 3.8%, respectively. There was no significant difference between the three groups in terms of IBTR (p: 0.06) and axillary recurrence (p: 0.08) rates. CONCLUSION: Breast conserving surgery can be applied using level II OPS techniques with the post-NAC radiological examination and marking even if primary tumor marking is not done in the pre-NAC period.

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Abstract OT2-2-02: Hypnosis and paravertebral block in breast cancer surgery: A pilot study to evaluate pain management and surgical margin status

10.1158/0008-5472.sabcs13-ot2-2-02 ◽

2013 ◽

Author(s):

M Cottrel ◽

M Podeur ◽

D Le Joliff ◽

P Amouroux ◽

M Assael ◽

...

Keyword(s):

Breast Cancer ◽

Pain Management ◽

Pilot Study ◽

Surgical Margin ◽

Cancer Surgery ◽

Margin Status ◽

Paravertebral Block ◽

Breast Cancer Surgery

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Risk factors for loco-regional recurrence after breast conserving surgery: impact of young age and surgical margin status in breast cancer patients

International Surgery Journal ◽

10.18203/2349-2902.isj20183713 ◽

2018 ◽

Vol 5 (9) ◽

pp. 2952

Author(s):

Mahtab Vasigh ◽

Soodeh Rahmani ◽

Ramesh Omranipour ◽

Shahpar Haghighat ◽

Ensiie Olfatbakhsh ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Hormone Therapy ◽

Univariate Analysis ◽

Significant Risk ◽

Surgical Margin ◽

Breast Conserving Surgery ◽

Margin Status ◽

Regional Recurrence

Background: Breast cancer is a common malignant tumor and treatment predominantly consists of surgery. Modern society has increased the demands of women to have higher requirements for breast appearance and quality of life. Therefore, exploring effective measures to control or reduce the rate of loco-regional recurrence (LRR) after breast conserving surgery (BCS) is the main focus of this study.Methods: This cohort included 743 consecutive patients with invasive breast cancer, treated with BCS in 2 centers in Tehran, Iran between 2005 and 2010. The primary endpoint was the rate of loco-regional recurrence in a 5-year follow- up period. Authors also investigated the factors that could predict LRR after BCS.Results: The prevalence of LRR after BCS was 7.6% in a median follow-up of 56.9 months. The Median time to local recurrence was 20.45 months. A correlation between follow-up outcome and age; histologic sub-type; surgical margin; number of positive nodes; complete pathologic response to neo-adjuvant chemotherapy; chemotherapy and hormone therapy was recognized. Surgical margin status, hormone therapy, histologic sub-type, age and Ki67 were shown to be significant risk factors for LRR in univariate analysis whereas surgical margin status emerged as an independent risk factor in multivariate analysis.Conclusions: Increased LRR was observed among those with higher ki67, aged under35, not receiving hormone therapy and with a surgical margin less than 2mm. These factors appeared to be risk factors for LRR after BCS, while, histologic grade, axillary nodal status, tumor size and biologic sub-type did not predict LRR after BCS.

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