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Positive margins after mastectomy increase breast cancer recurrence risk. Factors like age, BMI, and neoadjuvant chemotherapy can predict margin status, aiding in patient counseling.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Positive margins post-mastectomy elevate breast cancer recurrence risk and necessitate further treatment.
  • Identifying predictors of margin status is crucial for optimizing surgical outcomes.

Purpose of the Study:

  • To identify clinicopathologic factors associated with positive or close margins after mastectomy.
  • To inform surgical planning and patient counseling regarding mastectomy outcomes.

Main Methods:

  • Retrospective analysis of 938 women with Tis-T3 breast cancers undergoing mastectomy (2014-2020).
  • Comparison of clinicopathologic data between patients with negative margins (>1 mm) and close (≤1 mm) or positive margins.

Main Results:

  • 15% of patients had close or positive margins; 26% of these required re-excision, with 24% showing residual cancer.
  • Decreased risk of positive margins was associated with increasing age, higher BMI, and neoadjuvant chemotherapy.
  • Increased risk was linked to lower inner quadrant tumors, multifocal disease, immediate reconstruction, and high tumor-to-breast volume ratio.

Conclusions:

  • Age, BMI, tumor location, multifocality, neoadjuvant chemotherapy, immediate reconstruction, and tumor-to-breast volume ratio are independent predictors of mastectomy margin status.
  • These factors should guide preoperative counseling for patients undergoing mastectomy.