Does Breast Cancer Subtype Impact Margin Status in Patients Undergoing Partial Mastectomy?


Journal

The American surgeon
ISSN: 1555-9823
Titre abrégé: Am Surg
Pays: United States
ID NLM: 0370522

Informations de publication

Date de publication:
Jul 2022
Historique:
pubmed: 5 1 2022
medline: 16 6 2022
entrez: 4 1 2022
Statut: ppublish

Résumé

Molecular subtype in invasive breast cancer guides systemic therapy. It is unknown whether molecular subtype should also be considered to tailor surgical therapy. The present investigation was designed to evaluate whether breast cancer subtype impacted surgical margins in patients with invasive breast cancer stage I through III undergoing breast-conserving therapy. Data from 2 randomized trials evaluating cavity shave margins (CSM) on margin status in patients undergoing partial mastectomy (PM) were used for this analysis. Patients were included if invasive carcinoma was present in the PM specimen and data for all 3 receptors (ER, PR, and HER2) were known. Patients were classified as luminal if they were ER and/or PR positive; HER2 enriched if they were ER and PR negative but HER2 positive; and TN if they were negative for all 3 receptors. The impact of subtype on the margin status was evaluated at completion of standard PM, prior to randomization to CSM versus no CSM. Non-parametric statistical analyses were performed using SPSS Version 26. Molecular subtype was significantly correlated with race ( Molecular subtype does not predict margin status. Therefore, molecular subtype should not, independent of other factors, influence surgical decision-making.

Sections du résumé

BACKGROUND BACKGROUND
Molecular subtype in invasive breast cancer guides systemic therapy. It is unknown whether molecular subtype should also be considered to tailor surgical therapy. The present investigation was designed to evaluate whether breast cancer subtype impacted surgical margins in patients with invasive breast cancer stage I through III undergoing breast-conserving therapy.
METHODS METHODS
Data from 2 randomized trials evaluating cavity shave margins (CSM) on margin status in patients undergoing partial mastectomy (PM) were used for this analysis. Patients were included if invasive carcinoma was present in the PM specimen and data for all 3 receptors (ER, PR, and HER2) were known. Patients were classified as luminal if they were ER and/or PR positive; HER2 enriched if they were ER and PR negative but HER2 positive; and TN if they were negative for all 3 receptors. The impact of subtype on the margin status was evaluated at completion of standard PM, prior to randomization to CSM versus no CSM. Non-parametric statistical analyses were performed using SPSS Version 26.
RESULTS RESULTS
Molecular subtype was significantly correlated with race (
DISCUSSION CONCLUSIONS
Molecular subtype does not predict margin status. Therefore, molecular subtype should not, independent of other factors, influence surgical decision-making.

Identifiants

pubmed: 34982015
doi: 10.1177/00031348211069783
doi:

Substances chimiques

Receptor, ErbB-2 EC 2.7.10.1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1607-1612

Auteurs

Ileana Horattas (I)

Department of Surgery, 2569Cleveland Clinic Akron General, Akon, OH, USA.

Andrew Fenton (A)

Department of Surgery, 2569Cleveland Clinic Akron General, Akon, OH, USA.

Joseph Gabra (J)

Department of Surgery, 2569Cleveland Clinic Akron General, Akon, OH, USA.

Amanda Mendiola (A)

Department of Surgery, 2569Cleveland Clinic Akron General, Akon, OH, USA.

Fangyong Li (F)

Department of Surgery, 5755Yale University, New Haven, CT, USA.

Jukes Namm (J)

Department of Surgery, 23331Loma Linda University, Loma Linda, CA, USA.

Naveenraj Solomon (N)

Department of Surgery, 23331Loma Linda University, Loma Linda, CA, USA.

Jennifer Gass (J)

Department of Surgery, 22209Women and Infants Hospital, Providence, RI, USA.

Sharon Lum (S)

Department of Surgery, 23331Loma Linda University, Loma Linda, CA, USA.

Mary Murray (M)

Department of Surgery, 2569Cleveland Clinic Akron General, Akon, OH, USA.

Melissa Howard-McNatt (M)

Department of Surgery, 12279Wake Forest University, Winston-Salem, NC, USA.

Elisabeth Dupont (E)

Department of Surgery, 71461Watson Clinic, Lakeland, FL, USA.

Edward Levine (E)

Department of Surgery, 12279Wake Forest University, Winston-Salem, NC, USA.

Eric Brown (E)

Department of Surgery, 7005Beaumont Hospital, Troy, MI, USA.

David Ollila (D)

Department of Surgery, 2332University of North Carolina, Chapel Hill, NC, USA.

Akiko Chiba (A)

Department of Surgery, 12279Wake Forest University, Winston-Salem, NC, USA.

Anees B Chagpar (AB)

Department of Surgery, 5755Yale University, New Haven, CT, USA.

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