Factors Associated with Positive Margin Requiring Re-Excision after Oncoplastic Breast-Conserving Surgery

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Re-excision after breast-conserving surgery (BCS) is common, but factors influencing re-excision after oncoplastic BCS (OBCS) are less understood.
• Identifying predictors of positive margins is crucial for optimizing surgical outcomes and patient care in OBCS.

Purpose of the Study:

• To identify clinicopathological factors associated with positive margins requiring re-excision following OBCS.
• To compare these factors with those known to affect re-excision rates after standard BCS.

Main Methods:

• A retrospective review of patients undergoing OBCS from October 2021 to May 2024.
• Analysis of factors including patient demographics, comorbidities, tumor characteristics (size, multifocality, microcalcifications), and specific tumor pathologies (DCIS, IDC, invasive lobular carcinoma), and biomarker status (HER2, triple-negative).

Main Results:

• Ductal carcinoma in situ (DCIS) pathology was significantly associated with the need for re-excision (50% of cases).
• Invasive ductal carcinoma (IDC) pathology was significantly associated with *not* requiring re-excision (12.5% of cases).
• No significant correlation was found for age, BMI, smoking, hypertension, diabetes, tumor size, invasive lobular carcinoma, HER2+, or triple-negative status with re-excision needs.

Conclusions:

• While many factors associated with re-excision after BCS did not apply to OBCS, DCIS pathology remains a significant predictor for re-excision after OBCS.
• The presence of IDC appears to be negatively associated with re-excision after OBCS, suggesting different margin behavior compared to DCIS.
• These findings highlight the importance of considering specific tumor pathology in the context of OBCS to anticipate and potentially mitigate the need for re-excision.