Cargando…

Predictors of Surgical Margin Following Breast-Conserving Surgery: A Large Population-Based Cohort Study

BACKGROUND: The purpose of this retrospective, population-based, cohort study was to identify patient and tumor characteristics that are associated with a high risk of tumor-positive margins after breast-conserving surgery (BCS) to optimize preoperative counseling. METHODS: All patients with invasiv...

Descripción completa

Detalles Bibliográficos
Autor principal: van Deurzen, Carolien H. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5149558/
https://www.ncbi.nlm.nih.gov/pubmed/27590331
http://dx.doi.org/10.1245/s10434-016-5532-5
_version_ 1782474028935544832
author van Deurzen, Carolien H. M.
author_facet van Deurzen, Carolien H. M.
author_sort van Deurzen, Carolien H. M.
collection PubMed
description BACKGROUND: The purpose of this retrospective, population-based, cohort study was to identify patient and tumor characteristics that are associated with a high risk of tumor-positive margins after breast-conserving surgery (BCS) to optimize preoperative counseling. METHODS: All patients with invasive breast cancer (IBC) reported according to the synoptic reporting module in the Dutch Pathology Registry between 2009 and 2015 were included (n = 42.048 cases). Data extraction included age, type of surgery, several tumor characteristics, and resection margin status according to the Dutch indications for re-excision (free, focally positive, or more than focally positive). Univariate and multivariate tests were used to determine the association between clinicopathological features and margin status, restricted to patients with BCS. RESULTS: Of 42,048 cases, a total of 25,315 cases (60.2 %) with IBC underwent BCS. Of these patients, 2578 patients (10.2 %) had focally positive resection margins and 1665 (6.6 %) had more than focally positive resection margins. By univariate analysis, the following features were significantly associated with involved margins: age < 60 years, multifocality, lobular subtype, tumor size >2 cm, intermediate- and high-grade, positive ER status, positive Her2 status, angio-invasion, and the presence/extent of a ductal carcinoma in situ (DCIS) component. In multivariate logistic regression, the variables with the strongest association with involved margins (OR > 2) were multifocality, lobular subtype, large tumor size, and the presence of DCIS. CONCLUSIONS: Several clinicopathologic features are associated with involved resection margins after BCS for IBC. Assessment of these features preoperatively could be used to optimize preoperative counseling.
format Online
Article
Text
id pubmed-5149558
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Springer International Publishing
record_format MEDLINE/PubMed
spelling pubmed-51495582016-12-23 Predictors of Surgical Margin Following Breast-Conserving Surgery: A Large Population-Based Cohort Study van Deurzen, Carolien H. M. Ann Surg Oncol Breast Oncology BACKGROUND: The purpose of this retrospective, population-based, cohort study was to identify patient and tumor characteristics that are associated with a high risk of tumor-positive margins after breast-conserving surgery (BCS) to optimize preoperative counseling. METHODS: All patients with invasive breast cancer (IBC) reported according to the synoptic reporting module in the Dutch Pathology Registry between 2009 and 2015 were included (n = 42.048 cases). Data extraction included age, type of surgery, several tumor characteristics, and resection margin status according to the Dutch indications for re-excision (free, focally positive, or more than focally positive). Univariate and multivariate tests were used to determine the association between clinicopathological features and margin status, restricted to patients with BCS. RESULTS: Of 42,048 cases, a total of 25,315 cases (60.2 %) with IBC underwent BCS. Of these patients, 2578 patients (10.2 %) had focally positive resection margins and 1665 (6.6 %) had more than focally positive resection margins. By univariate analysis, the following features were significantly associated with involved margins: age < 60 years, multifocality, lobular subtype, tumor size >2 cm, intermediate- and high-grade, positive ER status, positive Her2 status, angio-invasion, and the presence/extent of a ductal carcinoma in situ (DCIS) component. In multivariate logistic regression, the variables with the strongest association with involved margins (OR > 2) were multifocality, lobular subtype, large tumor size, and the presence of DCIS. CONCLUSIONS: Several clinicopathologic features are associated with involved resection margins after BCS for IBC. Assessment of these features preoperatively could be used to optimize preoperative counseling. Springer International Publishing 2016-09-02 2016 /pmc/articles/PMC5149558/ /pubmed/27590331 http://dx.doi.org/10.1245/s10434-016-5532-5 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Breast Oncology
van Deurzen, Carolien H. M.
Predictors of Surgical Margin Following Breast-Conserving Surgery: A Large Population-Based Cohort Study
title Predictors of Surgical Margin Following Breast-Conserving Surgery: A Large Population-Based Cohort Study
title_full Predictors of Surgical Margin Following Breast-Conserving Surgery: A Large Population-Based Cohort Study
title_fullStr Predictors of Surgical Margin Following Breast-Conserving Surgery: A Large Population-Based Cohort Study
title_full_unstemmed Predictors of Surgical Margin Following Breast-Conserving Surgery: A Large Population-Based Cohort Study
title_short Predictors of Surgical Margin Following Breast-Conserving Surgery: A Large Population-Based Cohort Study
title_sort predictors of surgical margin following breast-conserving surgery: a large population-based cohort study
topic Breast Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5149558/
https://www.ncbi.nlm.nih.gov/pubmed/27590331
http://dx.doi.org/10.1245/s10434-016-5532-5
work_keys_str_mv AT vandeurzencarolienhm predictorsofsurgicalmarginfollowingbreastconservingsurgeryalargepopulationbasedcohortstudy