In:
Journal of Surgical Oncology, Wiley, Vol. 125, No. 4 ( 2022-03), p. 577-588
Abstract:
Optimal margins for ductal carcinoma in situ (DCIS) remain controversial in breast‐conserving surgery (BCS) and mastectomy. We examine the association of positive margins, reoperations, DCIS and age. Methods A retrospective study of histopathological reports (4489 patients). Margin positivity was defined as ink on tumor for invasive carcinoma. For DCIS, we applied 2 mm anterior and side margin thresholds, and ink on tumor in the posterior margin. Results The incidence of positive side margins was 20% in BCS and 5% in mastectomies ( p 〈 0.001). Of these patients, 68% and 14% underwent a reoperation ( p 〈 0.001). After a positive side margin in BCS, the reoperation rates according to age groups were 74% ( 〈 49), 69% (50–64), 68% (65–79), and 42% (80+) ( p = 0.013). Of BCS patients with invasive carcinoma in the side margin, 73% were reoperated on. A reoperation was performed in 70% of patients with a close (≤1 mm) DCIS side margin, compared to 43% with a wider (1.1–2 mm) margin ( p = 0.002). The reoperation rates were 55% in invasive carcinoma with close DCIS, 66% in close extensive intraductal component (EIC), and 83% in close pure DCIS ( p 〈 0.001). Conclusions Individual assessment as opposed to rigid adherence to guidelines was used in the decision on reoperation.
Type of Medium:
Online Resource
ISSN:
0022-4790
,
1096-9098
Language:
English
Publisher:
Wiley
Publication Date:
2022
detail.hit.zdb_id:
1475314-5
