Positive margins (R1) risk factors in breast cancer conservative surgery

Augusto Lombardi,1 Elena Pastore,1 Stefano Maggi,1 Gianluca Stanzani,2 Valeria Vitale,2 Camilla Romano,1 Laura Bersigotti,1 Andrea Vecchione,3 Claudio Amanti11Breast Surgery, Università La Sapienza, Ospedale Sant’Andrea, Rome, Italy; 2Breast Surgery, Ospedale Sant’Andr...

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Autores principales:	Lombardi A, Pastore E, Maggi S, Stanzani G, Vitale V, Romano C, Bersigotti L, Vecchione A, Amanti C
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Margin status Breast conserving therapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/1549c071bc9a40e98f5e7dca04f52f47
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spelling	oai:doaj.org-article:1549c071bc9a40e98f5e7dca04f52f472021-12-02T08:35:40ZPositive margins (R1) risk factors in breast cancer conservative surgery1179-1314https://doaj.org/article/1549c071bc9a40e98f5e7dca04f52f472019-07-01T00:00:00Zhttps://www.dovepress.com/positive-margins-r1-risk-factors-in-breast-cancer-conservative-surgery-peer-reviewed-article-BCTThttps://doaj.org/toc/1179-1314Augusto Lombardi,1 Elena Pastore,1 Stefano Maggi,1 Gianluca Stanzani,2 Valeria Vitale,2 Camilla Romano,1 Laura Bersigotti,1 Andrea Vecchione,3 Claudio Amanti11Breast Surgery, Università La Sapienza, Ospedale Sant’Andrea, Rome, Italy; 2Breast Surgery, Ospedale Sant’Andrea, Rome, Italy; 3Department of Pathology, Università La Sapienza, Ospedale Sant’Andrea, Rome, ItalyBackground: The primary goal in conservative breast cancer surgery is the complete excision of the tumor, but at the same time attempting to obtain a satisfactory postoperative esthetic result. The notion of “No Ink on Tumor” that indicates exclusively the presence of tumor cells on the inked surface of the surgical specimen is now the gold standard; however, the problem of the free margin is still a fundamental topic of debate that has not yet found a definitive solution.Methods: Our retrospective analysis takes into account 1440 patients undergoing breast conservative surgery, from October 2004 to November 2018, all treated at the breast unit of our institution.Results: Positive margins (R1) rate was 10.2% (147 cases out of 1440). Overall survival was 95% at 5 years and 89% at 10 years. No differences in mortality and local recurrence rate between R0 and R1 patients were found. Half of the R1 patients underwent secondary surgery with enlargement of margins, while in the other half we performed direct mastectomy. Among the analyzed variables, age, histological size, histological type, grading, multifocality, lympho-vascular invasion and lymph node status were significantly correlated with the R1 status. The multivariate analysis shows  the association of age and surgical technique (oncoplastic) with R1 status.Conclusion: Further studies will allow the creation of a statistical model, for better pre-operative prediction of patients with higher risk of R1 and better selection of patients to be candidates for conservative surgery.Keywords: breast-conserving therapy, margin status, age, oncoplastic surgeryLombardi APastore EMaggi SStanzani GVitale VRomano CBersigotti LVecchione AAmanti CDove Medical PressarticleMargin statusBreast conserving therapyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol Volume 11, Pp 243-248 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Margin status Breast conserving therapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Margin status Breast conserving therapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Lombardi A Pastore E Maggi S Stanzani G Vitale V Romano C Bersigotti L Vecchione A Amanti C Positive margins (R1) risk factors in breast cancer conservative surgery
description	Augusto Lombardi,1 Elena Pastore,1 Stefano Maggi,1 Gianluca Stanzani,2 Valeria Vitale,2 Camilla Romano,1 Laura Bersigotti,1 Andrea Vecchione,3 Claudio Amanti11Breast Surgery, Università La Sapienza, Ospedale Sant’Andrea, Rome, Italy; 2Breast Surgery, Ospedale Sant’Andrea, Rome, Italy; 3Department of Pathology, Università La Sapienza, Ospedale Sant’Andrea, Rome, ItalyBackground: The primary goal in conservative breast cancer surgery is the complete excision of the tumor, but at the same time attempting to obtain a satisfactory postoperative esthetic result. The notion of “No Ink on Tumor” that indicates exclusively the presence of tumor cells on the inked surface of the surgical specimen is now the gold standard; however, the problem of the free margin is still a fundamental topic of debate that has not yet found a definitive solution.Methods: Our retrospective analysis takes into account 1440 patients undergoing breast conservative surgery, from October 2004 to November 2018, all treated at the breast unit of our institution.Results: Positive margins (R1) rate was 10.2% (147 cases out of 1440). Overall survival was 95% at 5 years and 89% at 10 years. No differences in mortality and local recurrence rate between R0 and R1 patients were found. Half of the R1 patients underwent secondary surgery with enlargement of margins, while in the other half we performed direct mastectomy. Among the analyzed variables, age, histological size, histological type, grading, multifocality, lympho-vascular invasion and lymph node status were significantly correlated with the R1 status. The multivariate analysis shows  the association of age and surgical technique (oncoplastic) with R1 status.Conclusion: Further studies will allow the creation of a statistical model, for better pre-operative prediction of patients with higher risk of R1 and better selection of patients to be candidates for conservative surgery.Keywords: breast-conserving therapy, margin status, age, oncoplastic surgery
format	article
author	Lombardi A Pastore E Maggi S Stanzani G Vitale V Romano C Bersigotti L Vecchione A Amanti C
author_facet	Lombardi A Pastore E Maggi S Stanzani G Vitale V Romano C Bersigotti L Vecchione A Amanti C
author_sort	Lombardi A
title	Positive margins (R1) risk factors in breast cancer conservative surgery
title_short	Positive margins (R1) risk factors in breast cancer conservative surgery
title_full	Positive margins (R1) risk factors in breast cancer conservative surgery
title_fullStr	Positive margins (R1) risk factors in breast cancer conservative surgery
title_full_unstemmed	Positive margins (R1) risk factors in breast cancer conservative surgery
title_sort	positive margins (r1) risk factors in breast cancer conservative surgery
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/1549c071bc9a40e98f5e7dca04f52f47
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Positive margins (R1) risk factors in breast cancer conservative surgery

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