Breast-Conserving Surgeries With and Without Cavity Shave Margins Have Different Re-excision Rates and Associated Overall Cost: Institutional and Patient-Driven Decisions for Its Utilization
| Autor: | Raghavendra Pillappa, Michael O. Idowu, Kandace P. McGuire, Patricija Zot, Valentina Robila, Lorraine Colon Cartagena |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Reoperation Cancer Research medicine.medical_specialty medicine.medical_treatment Partial mastectomy Breast Neoplasms Mastectomy Segmental Resection 03 medical and health sciences 0302 clinical medicine Breast cancer medicine Breast-conserving surgery Positive Margins Humans Stage (cooking) Re-Excision Aged Neoplasm Staging Retrospective Studies business.industry Lumpectomy Carcinoma Ductal Breast Middle Aged medicine.disease Surgery 030104 developmental biology Oncology 030220 oncology & carcinogenesis Female business Follow-Up Studies |
| Zdroj: | Clinical breast cancer. 21(5) |
| ISSN: | 1938-0666 |
| Popis: | Background Reducing the rate of margin positivity and reoperations remains a paramount goal in breast-conserving surgery (BCS). This study assesses the effectiveness of standard partial mastectomy with cavity shave margins (CSM) compared with partial mastectomy with selective margin resection (SPM), with regard to outcomes of the initial surgeries, re-excisions, and overall costs. Patients and Methods This is a retrospective review of 122 eligible breast cancer patients who underwent BCS at one institution. The CSM and SPM groups each included 61 patients, matched for presurgical diagnoses and clinical stage. Data including margin status, rates and reason for re-excision, associated operation times, and costs were analyzed. Results Patients undergoing CSM had less than half the rate of positive margins (PMs) (10% vs. 23%; P = .03) and re-excisions (8% vs. 23%; P = .02) compared with SPM. In the former group, the margin involvement was focal, and re-excisions were performed almost exclusively for PMs. For SPM, the majority (92%) of PMs were on the main lumpectomy specimen rather than the selective margins, and re-excisions included, in addition to PMs, extensive or multifocal negative but close margins. Reduced breast tissue volumes were removed with CSM, particularly for patients undergoing a single surgery (47 vs. 165 cm3; P Conclusion Circumferential cavity shaving, associated with consistent lower PMs, tissue volumes excised, and re-excision rates, is appropriate for routine implementation as a method offering superior surgical outcomes. |
| Databáze: | OpenAIRE |
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