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Predictors of margin status after breast-conserving operations in an underscreened population
Rozbeh Torabi1, Chiu-Hsieh Hsu, Prahladbhai N Patel
1Department of Surgery, Maricopa Medical Center, Hogan Building, 2nd Floor 2601 E Roosevelt Street, 85008 Phoenix, AZ, USA.
Langenbeck'S Archives of Surgery
|November 28, 2012
Summary
Positive margins after lumpectomy are a concern. In underscreened populations, preoperative chemotherapy use was the strongest predictor of achieving negative margins in breast cancer surgery.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Surgery
Background:
- Positive margins after lumpectomy are a significant challenge in breast cancer treatment.
- Achieving negative margins is crucial for reducing local recurrence rates.
Purpose of the Study:
- To identify patient-related variables associated with positive margins after lumpectomy.
- To investigate factors influencing margin status in an underscreened population.
Main Methods:
- Retrospective review of breast-conserving operations from 2001-2010.
- Evaluation of sociodemographic, clinical, and treatment variables.
- Univariate and multivariate analyses to determine predictors of margin status.
Main Results:
- 31% of patients had positive margins; 36% utilized screening mammography.
- Positive margins were associated with palpable mass and poor screening mammography use.
- Histopathologic factors like larger size, lymph node involvement, LVI, and EIC increased positive margin risk.
- Preoperative chemotherapy use was linked to negative margins.
Conclusions:
- Poor histologic grade, lymphovascular invasion (LVI), and extensive intraductal component (EIC) are associated with positive margins.
- Preoperative chemotherapy is the strongest predictor of achieving negative margins in lumpectomy patients.
