Risk factors for positive resection margins of breast cancer tumorectomy specimen following breast-conserving surgery.

Détails

ID Serval
serval:BIB_29AEEDE4A258
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Risk factors for positive resection margins of breast cancer tumorectomy specimen following breast-conserving surgery.
Périodique
Hormone molecular biology and clinical investigation
Auteur(s)
Heiss N., Rousson V., Ifticene-Treboux A., Lehr H.A., Delaloye J.F.
ISSN
1868-1891 (Electronic)
ISSN-L
1868-1883
Statut éditorial
Publié
Date de publication
09/12/2017
Peer-reviewed
Oui
Volume
32
Numéro
2
Pages
2
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Background The aim of the study was to identify risk factors for positive surgical margins in breast-conserving surgery for breast cancer and to evaluate the influence of surgical experience in obtaining complete resection. Methods All lumpectomies for invasive breast carcinoma and ductal carcinoma in situ (DCIS) between April 2008 and March 2010 were selected from the database of a single institution. Re-excision rates for positive margins as well as patient and histopathologic tumor characteristics were analyzed. Surgical experience was staged by pairs made of Resident plus Specialist or Consultant. Two periods were defined. During period A, the majority of operations were performed by Residents under supervision of Specialist or Consultant. During period B, only palpable tumors were operated by Residents. Results The global re-excision rate was 27% (50 of 183 patients). The presence of DCIS increased the risk for positive margins: 60% (nine of 15 patients) in the case of sole DCIS compared to 26% (41 of 160 patients) for invasive cancer (p = 0.005) and 35% (42 of 120 patients) in the case of peritumoral DCIS compared to 11% (seven of 62 patients) in the case of sole invasive cancer (p = 0.001). Re-excision rate decreased from 36% (23 of 64 patients) during period A to 23% (27 of 119 patients) during period B (p = 0.055). There was no significant difference between the surgical pairs. Conclusion In our study, DCIS was the only risk factor for positive surgical margins. Breast-conserving surgery for non-palpable tumors should be performed by Specialists, however, palpable tumors can be safely operated by Residents under supervision.
Mots-clé
Breast Neoplasms/pathology, Breast Neoplasms/surgery, Carcinoma, Ductal/pathology, Carcinoma, Ductal/surgery, Female, Humans, Margins of Excision, Mastectomy, Segmental/adverse effects, Middle Aged, Neoplasm Invasiveness, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Postoperative Complications/pathology, breast cancer, breast-conserving surgery, palpable tumor, surgical experience, surgical margins
Pubmed
Web of science
Création de la notice
19/12/2017 16:37
Dernière modification de la notice
20/08/2019 13:09
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