Rate of residual tumor after repeat surgery for positive margins in ductal carcinoma in Situ, and predictive factors
Résumé
Aims: To evaluate the rate of residual tumor in re-excision specimen of patients with positive margins in ductal
carcinoma in situ (DCIS) following breast-conservative surgery, and to identify predictive factors of residual
tumor.
Material and methods: We conducted a monocentric, retrospective study, from January 2010 to December 2020.
All 103 patients who underwent re-excision for positive margins in DCIS following breast-conservative surgery
for in situ or invasive breast carcinoma were included. Positive margins were defined as inferior to 2 mm from
the DCIS component. Two groups were defined, depending on the presence of residual tumor or not, and were
compared on their clinical and histopathological characteristics to identify predictive factors of residual tumor.
Results: Residual tumor was found in re-excision specimen of 46 patients (44.7 %). The risk of residual tumor was
increased in patients with more than 2 tumor foci (aOR: 12.4; 95 % CI: 1.2 -124.1; p = 0.032) and in those with
extensive margin involvement (aOR: 3.2; 95 % CI: 1.3–8.2; p = 0.013). Finally, surgery performed after 2013 was
associated with a lower risk of residual tumor (aOR: 0.23; 95 % CI: 0.09–0.058; p = 0.002).
Conclusion: The rate of residual tumor in re-excision specimen of patients with positive margins in DCIS is high.
Both the number of tumor foci and the extension of positive margins were identified as risk factors. Finally, the
surgical learning curve for this procedure seems to be significantly correlated with the risk of residual tumor and
needs to be considered.
Domaines
Médecine humaine et pathologieOrigine | Fichiers produits par l'(les) auteur(s) |
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