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EnglishBackground: The oncologic benefit of upfront re-excision of involved margins after breast-conserving surgery in the context of current multimodal clinical management of breast cancer is unclear. The aim of the present study was to assess the 5-years locoregional recurrence (LRR)-free and distant metastases (DM)-free survival probabilities in patients not undergoing re-excision of positive margins after lumpectomy for breast cancer. Methods: A cohort of 104 patients with positive margins not undergoing re-excision was matched by propensity score with a cohort of 2006 control patients with clear margins after breast-conserving surgery, treated between 2008 and 2018. A multivariate survival analysis was performed accounting for all variables related to LRR and DM, including adjuvant treatments. Results: After adjusting for potential confounders, avoiding to re-excise a positive margin after lumpectomy had no effect on 5-years LRR-free survival probability (HR 0.98, 95%CI 0.36-2.67, p = 0.96) or 5-years DM-free survival probability (HR 0.37, 95%CI 0.08-1.61, p = 0.18). No correlation was found between occurrence of LRR and number of involved margins (HR 1.28, 95%CI 0.10-12.4, Log-rank p = 0.83), or extension of infiltrating disease (HR 1.21, 95%CI 0.20-7.40, Log-rank p = 0.83), but a trend toward higher LRR probability was found for invasive ductal (HR 6.92, 95%CI 0.7-68.8, Log-rank p = 0.10) and invasive lobular cancer (HR 12.95, 95%CI 0.79-213.6, Log-rank p = 0.07) on positive margins. Conclusions: In the era of multimodal treatment of breast cancer and accurate strategies to reduce the probability of residual disease in the post-lumpectomy cavity, re-excision of positive margins might be omitted in selected patients with low-risk breast cancers.
| Titolo: | Involved margins after lumpectomy for breast cancer: Always to be re-excised? |
| Autori: | SORRENTINO, LUCA (Primo) CORSI, FABIO RUGGERO MARIA (Ultimo) (Corresponding) |
| Parole Chiave: | Re-excision; Breast-conserving surgery; Breast cancer; Margins |
| Settore Scientifico Disciplinare: | Settore MED/18 - Chirurgia Generale |
| Data di pubblicazione: | set-2019 |
| Rivista: | |
| Tipologia: | Article (author) |
| Digital Object Identifier (DOI): | http://dx.doi.org/10.1016/j.suronc.2019.08.002 |
| Appare nelle tipologie: | 01 - Articolo su periodico |
File in questo prodotto:
| File | Descrizione | Tipologia | Licenza | |
|---|---|---|---|---|
| Re-excision preprint.pdf | Pre-print (manoscritto inviato all'editore) | Open Access Visualizza/Apri | ||
| 1-s2.0-S0960740419302002-main.pdf | Publisher's version/PDF | Administrator Richiedi una copia |
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