Related Experiment Video
Updated: Oct 26, 2025
06:46
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
448
Factors predicting residual disease on re-excision after breast conserving surgery
Duncan James Simpson1, Jennifer Allan1, Brendan McFall1
1Antrim Area Hospital, Bush Road, Antrim, Northern Ireland, BT41 2RL, United Kingdom.
Summary
Many patients with early breast cancer may avoid re-excision surgery. Identifying patients with small tumors and clear initial margins can predict low residual disease risk.
Area of Science:
- Oncology
- Surgical Pathology
- Breast Cancer Research
Background:
- Breast-conserving surgery is standard for early breast cancer.
- Unsatisfactory margins lead to re-excision in 25% of patients.
- Re-excision often reveals no residual disease, increasing morbidity and costs.
Purpose of the Study:
- Identify early breast cancer patients with unsatisfactory margins but low residual disease risk.
- Determine factors predicting residual disease to potentially avoid re-excision.
Main Methods:
- Retrospective analysis of 220 patients undergoing re-excision for positive margins post-breast-conserving surgery (Jan 2013-Oct 2019).
- Univariable and multivariable analyses to identify pathological predictors of residual disease.
Main Results:
- 41% of patients had residual disease.
- Factors predicting low residual disease risk: tumor size <20mm, pathological-to-radiological size ratio <1.5, and disease-free initial cavity shaves.
- Patients with all three factors had only a 14% chance of residual disease.
Conclusions:
- Over half of re-excisions for positive margins may be unnecessary.
- Tumor size and imaging findings are crucial in deciding on re-excision.
- Incorporate these factors alongside margin status for informed clinical decisions.
