Evaluating the relationship between ductal carcinoma in situ, calcifications, and margin status in patients undergoing breast conserving surgery.
ductal carcinoma in situ
intraoperative assessment
selective re-excision
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
04
12
2018
accepted:
14
01
2019
pubmed:
12
2
2019
medline:
18
4
2019
entrez:
12
2
2019
Statut:
ppublish
Résumé
Microcalcifications associated with ductal carcinoma in situ (DCIS-AMC) close to lumpectomy margins could be used as a surrogate for margin involvement and aid in decreasing margin re-excision. We sought to evaluate the histologic factors of DCIS-AMC near lumpectomy margins. Women with DCIS treated with breast-conserving surgery (BCS) who had DCIS-AMC on surgical specimens were identified. Pathology slides were reviewed to determine the distance of DCIS-AMC from each margin (six per specimen) and the distance of DCIS from each margin (ie, margin status). Of 35 patients (210 margins), 24 had close/positive margins (39 margins [18%]). DCIS-AMC≤10 mm from a margin was associated with a greater incidence of DCIS≤2 mm from the margin (31.7% DCIS-AMC≤10 mm vs 13.3% no DCIS-AMC≤10 mm, P = 0.003). On multivariable analysis, DCIS≤2 mm from the margin was independently associated with DCIS-AMC≤10 mm from the margin (odds ratio 2.95, 95% confidence interval 1.48-5.86, P = 0.002). DCIS-AMC≤10 mm from the inked margin is associated with DCIS at or close to the margin (≤2 mm). Using this knowledge, intraoperative techniques like specimen radiography could be utilized to detect microcalcifications≤10 mm from a margin and guide selective margin re-excision in BCS.
Sections du résumé
BACKGROUND
BACKGROUND
Microcalcifications associated with ductal carcinoma in situ (DCIS-AMC) close to lumpectomy margins could be used as a surrogate for margin involvement and aid in decreasing margin re-excision. We sought to evaluate the histologic factors of DCIS-AMC near lumpectomy margins.
METHODS
METHODS
Women with DCIS treated with breast-conserving surgery (BCS) who had DCIS-AMC on surgical specimens were identified. Pathology slides were reviewed to determine the distance of DCIS-AMC from each margin (six per specimen) and the distance of DCIS from each margin (ie, margin status).
RESULTS
RESULTS
Of 35 patients (210 margins), 24 had close/positive margins (39 margins [18%]). DCIS-AMC≤10 mm from a margin was associated with a greater incidence of DCIS≤2 mm from the margin (31.7% DCIS-AMC≤10 mm vs 13.3% no DCIS-AMC≤10 mm, P = 0.003). On multivariable analysis, DCIS≤2 mm from the margin was independently associated with DCIS-AMC≤10 mm from the margin (odds ratio 2.95, 95% confidence interval 1.48-5.86, P = 0.002).
CONCLUSIONS
CONCLUSIONS
DCIS-AMC≤10 mm from the inked margin is associated with DCIS at or close to the margin (≤2 mm). Using this knowledge, intraoperative techniques like specimen radiography could be utilized to detect microcalcifications≤10 mm from a margin and guide selective margin re-excision in BCS.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
694-699Informations de copyright
© 2019 Wiley Periodicals, Inc.