Cavity Shave Margins in Breast Conservative Surgery a Strategy to Reduce Positive Margins and Surgical Time.

Autor: Vanni G; Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy., Pellicciaro M; Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy.; PhD Program in Applied Medical-Surgical Sciences, Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy., Renelli G; Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy., Materazzo M; Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy.; PhD Program in Applied Medical-Surgical Sciences, Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy., Sadri A; Plastic Surgery, Great Ormond Hospital for Children NHS Foundation Trust, London WC1N3JH, UK., Marsella VE; Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy., Tacconi F; Unit of Thoracic Surgery, Department of Surgical Sciences, Tor Vergata University, 00133 Rome, Italy., Bastone SA; PhD Program in Applied Medical-Surgical Sciences, Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy.; Unit of Thoracic Surgery, Department of Surgical Sciences, Tor Vergata University, 00133 Rome, Italy., Longo B; Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy.; Plastic and Reconstructive Surgery at Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy., Di Mauro G; Medical Oncology Unit, Department of Human Pathology 'G. Barresi', University of Messina, 98122 Messina, Italy., Cervelli V; Plastic and Reconstructive Surgery at Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy., Berretta M; Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy., Buonomo OC; Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy.
Jazyk: angličtina
Zdroj: Current oncology (Toronto, Ont.) [Curr Oncol] 2024 Jan 16; Vol. 31 (1), pp. 511-520. Date of Electronic Publication: 2024 Jan 16.
DOI: 10.3390/curroncol31010035
Abstrakt: Background: Resection of additional tissue circumferentially around the cavity left by lumpectomy (cavity shave) was suggested to reduce rates of positive margins and re-excision. Methods: A single center retrospective study which analyzed margins status, re-excision, and surgical time in patients who underwent breast conserving surgery and cavity shave or intraoperative evaluation of resection margins. Results: Between 2021 and 2023, 594 patients were enrolled in the study. In patients subjected to cavity shave, a significant reduction in positive, focally positive, or closer margins was reported 8.9% vs. 18.5% ( p = 0.003). No difference was reported in terms of surgical re-excision ( p < 0.846) (5% vs. 5.5%). Surgical time was lower in patients subjected to cavity shave (<0.001). The multivariate analysis intraoperative evaluation of sentinel lymph node OR 1.816 and cavity shave OR 2.909 were predictive factors for a shorter surgical time. Excluding patients subjected to intraoperative evaluation of sentinel lymph node and patients with ductal carcinoma in situ, patients that underwent the cavity shave presented a reduced surgical time (67.9 + 3.8 min vs. 81.6 + 2.8 min) ( p = 0.006). Conclusions: Cavity shaving after lumpectomy reduced the rate of positive margins and it was associated with a significant reduction in surgical time compared to intraoperative evaluation of resection margins.
Databáze: MEDLINE
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