Influence of Surgical Margins on the Outcome of Breast Cancer Patients: A Retrospective Analysis

Bernardi, Sergio; Bertozzi, Serena; Londero, Ambrogio P.; Gentile, G; Angione, Vito; Petri, Roberto

doi:10.1007/s00268-014-2596-x

Cited by 19 publications

(17 citation statements)

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“…DCIS grows along the ducts in the breast without invasion of the underlying tissue, which results in a non-palpable lesion difficult to remove with tumor-free margins. When EDCIs are completely removed with negative tumor margins, it loses its predicative value for LRR [ 5 , 14 – 19 ]. In a pooled analysis of the EORTC 10801 and the DBCG 82 TM trials, lympho-vascular invasion causes a higher risk of LRR after BCT [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of loco-regional and distant recurrences in breast cancer after conservative surgery

et al. 2016

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BackgroundA number of patients treated conservatively for breast cancer will develop loco-regional and distant recurrences. Our aim was to determine how their occurrence may be linked to the evolution of the disease.MethodsWe analyzed 238 women treated by conservative breast surgery and breast irradiation in a single institution. We evaluated the prognostic factors associated with loco-regional and distant recurrences and the prognostic value of local and regional recurrences on systemic progression.ResultsAfter a median follow-up of 5 year (range 1–10), 16 (6.72 %) patients in the breast conservative surgery (BCS) groups had loco-regional recurrence. For distant recurrence, 10 (4.2 %) patients had experienced distant recurrence. Lympho-vascular invasion (HR 2.55; 95 % CI, 076 to 8.49) and an extensive intraductal component (HR, 2.22; 95 % CI, 0.69 to 7.15) and nodal status are risk factors for loco-regional recurrence (LRR) after breast conservative therapy (BCT). Tumor size, nodal status, high histologic grade, and breast cancer diagnosed at a young age (≤35 years) are correlated with higher distant recurrence rates after BCT.ConclusionsRisk factors for LRR after BCS include lympho-vascular invasion, extensive inraductal component, and high nodal status, where as risk factors for distant recurrence include tumor size, nodal status, high histologic grade, and breast cancer diagnosed at a young age (≤35 years).

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Section: Discussionmentioning

confidence: 99%

Analysis of loco-regional and distant recurrences in breast cancer after conservative surgery

et al. 2016

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“…For the present review, an updated literature search replicating that from Houssami et al [10, 12•] was performed in December 2015 to assess whether studies published subsequent to reports of the margins meta-analysis [ [38,39] have shown findings that are consistent with the conclusions of the margin metaanalysis [12•]. However, a study conducted in Australia based on 2300 patients with invasive BC reported that a positive margin or a margin of 1 mm (for margins obtained at BCS or mastectomy) had an increased risk of LR (HR 2.72; 95 % CI 1.30-5.69), whilst margins of 2 mm or wider were not associated with increased risk of LR; on that basis, the study from Behm et al recommended a 2-mm width for negative margins [40].…”

Section: Is There New Evidence To Contradict a Recommendation For A Mmentioning

confidence: 99%

Margins in Breast-Conserving Surgery for Early Breast Cancer: How Much is Good Enough?

Houssami

Marinovich

2016

Curr Breast Cancer Rep

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Breast-conserving therapy (breast-conserving surgery (BCS) and radiation therapy) is an effective treatment for early-stage breast cancer (BC). Whilst there is consensus that risk of local recurrence (LR) following BCS is increased if the surgical margins are positive ('ink on tumour'), consensus on what constitutes adequate negative margins has been elusive despite studies spanning decades. Recent SSO-ASTRO guidelines have recommended 'no ink on tumour' as the standard for negative margins in BCS for invasive BC. These were underpinned by study-level meta-analysis reporting that a minimally defined negative margin width be adopted for BCS in invasive BC and showing that wider (than a minimum >1 mm) negative margins do not significantly reduce LR risk. Recommendations on a minimum margin width for ductal carcinoma in situ (DCIS) vary substantially from >1 to 10 mm or wider; evidence-based guidelines are being developed and are expected to address 'how much is enough' for margin width in DCIS.

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“…The specimen is then oriented with some stitched in order to facilitate the margin evaluation by the pathologist [83]. In particular, a negative margin greater than 2 mm represents nowadays the adequate margin for DCIS [84].…”

Section: Conservative Breast Surgerymentioning

confidence: 99%

Breast and Axilla Treatment in Ductal Carcinoma In Situ

Londero¹,

Bertozzi²,

Vora³

et al. 2018

Cancer Management and Therapy

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Ductal carcinoma in situ (DCIS) represents a challenge for the breast unit team, beginning from its difficult radiological detection and continuing with its controversial multimodal treatment and management. With the introduction of the mammographic screening, DCIS has become a common diagnosis. In fact, today DCIS is mostly identified by mammography or magnetic resonance imaging (MRI). The increased prevalence of DCIS diagnosis, in the past, raised the problem of the therapeutic management. In this chapter, the breast and axillary surgery in case of DCIS and the most controversial aspects regarding DCIS management are reviewed based on international guidelines and on the current literature.

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Influence of Surgical Margins on the Outcome of Breast Cancer Patients: A Retrospective Analysis

Cited by 19 publications

References 50 publications

Analysis of loco-regional and distant recurrences in breast cancer after conservative surgery

Analysis of loco-regional and distant recurrences in breast cancer after conservative surgery

Margins in Breast-Conserving Surgery for Early Breast Cancer: How Much is Good Enough?

Breast and Axilla Treatment in Ductal Carcinoma In Situ

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