Background: The primary goal in conservative breast cancer surgery is the complete excision of the tumor, but at the same time attempting to obtain a satisfactory postoperative esthetic result. The notion of “No Ink on Tumor” that indicates exclusively the presence of tumor cells on the inked surface of the surgical specimen is now the gold standard; however, the problem of the free margin is still a fundamental topic of debate that has not yet found a definitive solution. Methods: Our retrospective analysis takes into account 1440 patients undergoing breast conservative surgery, from October 2004 to November 2018, all treated at the breast unit of our institution. Results: Positive margins (R1) rate was 10.2% (147 cases out of 1440). Overall survival was 95% at 5 years and 89% at 10 years. No differences in mortality and local recurrence rate between R0 and R1 patients were found. Half of the R1 patients underwent secondary surgery with enlargement of margins, while in the other half we performed direct mastectomy. Among the analyzed variables, age, histological size, histological type, grading, multifocality, lympho-vascular invasion and lymph node status were significantly correlated with the R1 status. The multivariate analysis shows the association of age and surgical technique (oncoplastic) with R1 status. Conclusion: Further studies will allow the creation of a statistical model, for better preoperative prediction of patients with higher risk of R1 and better selection of patients to be candidates for conservative surgery.

Positive margins (R1) risk factors in breast cancer conservative surgery / Lombardi, Augusto; Pastore, Elena; Maggi, Stefano; Stanzani, Gianluca; Vitale, Valeria; Romano, Camilla; Bersigotti, Laura; Vecchione, Andrea; Amanti, Claudio. - In: BREAST CANCER. - ISSN 1179-1314. - 11:Jul 26(2019), pp. 243-248. [10.2147/BCTT.S210788]

Positive margins (R1) risk factors in breast cancer conservative surgery

Augusto Lombardi
Primo
Membro del Collaboration Group
;
Stefano Maggi;Laura Bersigotti;Andrea Vecchione;Claudio Amanti
2019

Abstract

Background: The primary goal in conservative breast cancer surgery is the complete excision of the tumor, but at the same time attempting to obtain a satisfactory postoperative esthetic result. The notion of “No Ink on Tumor” that indicates exclusively the presence of tumor cells on the inked surface of the surgical specimen is now the gold standard; however, the problem of the free margin is still a fundamental topic of debate that has not yet found a definitive solution. Methods: Our retrospective analysis takes into account 1440 patients undergoing breast conservative surgery, from October 2004 to November 2018, all treated at the breast unit of our institution. Results: Positive margins (R1) rate was 10.2% (147 cases out of 1440). Overall survival was 95% at 5 years and 89% at 10 years. No differences in mortality and local recurrence rate between R0 and R1 patients were found. Half of the R1 patients underwent secondary surgery with enlargement of margins, while in the other half we performed direct mastectomy. Among the analyzed variables, age, histological size, histological type, grading, multifocality, lympho-vascular invasion and lymph node status were significantly correlated with the R1 status. The multivariate analysis shows the association of age and surgical technique (oncoplastic) with R1 status. Conclusion: Further studies will allow the creation of a statistical model, for better preoperative prediction of patients with higher risk of R1 and better selection of patients to be candidates for conservative surgery.
2019
breast-conserving therapy; margin status; age, oncoplastic surgery
01 Pubblicazione su rivista::01a Articolo in rivista
Positive margins (R1) risk factors in breast cancer conservative surgery / Lombardi, Augusto; Pastore, Elena; Maggi, Stefano; Stanzani, Gianluca; Vitale, Valeria; Romano, Camilla; Bersigotti, Laura; Vecchione, Andrea; Amanti, Claudio. - In: BREAST CANCER. - ISSN 1179-1314. - 11:Jul 26(2019), pp. 243-248. [10.2147/BCTT.S210788]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1303271
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