ArticleAnnals of surgical oncology2016
Early Adoption of the SSO-ASTRO Consensus Guidelines on Margins for Breast-Conserving Surgery with Whole-Breast Irradiation in Stage I and II Invasive Breast Cancer: Initial Experience from Memorial Sloan Kettering Cancer Center.
Article in Annals of surgical oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Deimplementation of the Choosing Wisely Recommendations for Low-Value Breast Cancer Surgery: A Systematic Review.JAMA surgery · 2020Pooled it
- Intraoperative fluorescence imaging with aminolevulinic acid detects grossly occult breast cancer: a phase II randomized controlled trial.Breast cancer research : BCR · 2021Trial
- Implementation and benchmarking of a novel analytical framework to clinically evaluate tumor-specific fluorescent tracers.Nature communications · 2018Trial
- MRI-based radiomic models to predict surgical margin status and infer tumor immune microenvironment in breast cancer patients with breast-conserving surgery: a multicenter validation study.European radiology · 2024Article
- Impact of SSO-ASTRO Margin Guidelines on Re-excision Rate in Breast-conserving Surgery: A Single-center Experience.Journal of cancer & allied specialties · 2024Article
- Residual Risk of Ipsilateral Tumor Recurrence in Patients Who Achieved Clear Lumpectomy Margins After Repeated Resection.Journal of breast cancer · 2023Article
- Analysis of Specimen Mammography with Artificial Intelligence to Predict Margin Status.Annals of surgical oncology · 2023Article
- Cost minimization in breast conserving surgery: a comparative study of radiofrequency spectroscopy and full cavity shave margins.Cost effectiveness and resource allocation : C/E · 2023Article
- Rates of reoperation after breast conserving cancer surgery in Western Australia before and after publication of the SSO-ASTRO margins guideline.Breast (Edinburgh, Scotland) · 2023Article
- A Randomized Controlled Trial for Doing vs. Omitting Intraoperative Frozen Section Biopsy for Resection Margin Status in Selected Patients Undergoing Breast-Conserving Surgery (OFF-MAP Trial).Journal of breast cancer · 2021Article
- Prognostic factors for residual occult disease in shave margins during partial mastectomy.Breast cancer research and treatment · 2021Article
- Impact of SSO-ASTRO "No Ink on Tumor" Guidelines on Reexcision Rates among Older Breast Cancer Patients.Annals of surgical oncology · 2021Article
- Strategies for the selection of oncoplastic techniques in the treatment of early-stage breast cancer patients.Gland surgery · 2021Article
- Similar rates of residual disease in patients with DCIS within 2 mm of lumpectomy margin regardless of the presence of invasive carcinoma.Breast cancer research and treatment · 2021Article
- Adoption of SSO-ASTRO Margin Guidelines for Ductal Carcinoma in Situ: What Is the Impact on Use of Additional Surgery?Annals of surgical oncology · 2021Article
- The Value of Repeated Breast Surgery as a Quality Indicator in Breast Cancer Care.Annals of surgical oncology · 2021Article
- Atypical ductal hyperplasia bordering on DCIS on core biopsy is associated with higher risk of upgrade than conventional atypical ductal hyperplasia.Breast cancer research and treatment · 2020Article
- Accuracy of gross intraoperative margin assessment for breast cancer: experience since the SSO-ASTRO margin consensus guidelines.Scientific reports · 2020Article
- Reoperation rate after breast conserving surgery as quality indicator in breast cancer treatment: A reappraisal.Breast (Edinburgh, Scotland) · 2020Article
- Chest wall perforator flaps in partial breast reconstruction after breast conservation surgery: an additional oncoplastic surgical option.Ecancermedicalscience · 2020Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundReexcision rates in patients undergoing breast-conserving surgery (BCS) for early-stage invasive breast cancer are highly variable. The Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) published consensus guidelines to help standardize practice. We sought to determine reexcision rates before and after guideline adoption at our institution.
methodsWe identified patients with stage I or II invasive breast cancer initially treated with BCS between June 1, 2013, and October 31, 2014. Margins were defined as positive (tumor on ink), close (≤1 mm), or negative (>1 mm), and were recorded for both invasive cancer and ductal carcinoma-in situ (DCIS) components. Reexcision rates were quantified, characteristics were compared between groups, and multivariable logistic regression was performed.
resultsA total of 1205 patients were identified, 504 before and 701 after the guideline adoption (January 1, 2014). Clinical and pathologic characteristics were similar between time periods. Reexcision rates significantly declined from 21.4 to 15.1 % (p = 0.006) after guideline adoption. A multivariable model identified extensive intraductal component (odds ratio [OR] 2.5, 95 % confidence interval [CI] 1.2-5.2), multifocality (OR 2.0, 95 % CI 1.2-3.6), positive (OR 844.4, 95 % CI 226.3-5562.5) and close (OR 38.3, 95 % CI 21.5-71.8) ductal carcinoma-in situ margin, positive (OR 174.2, 95 % CI 66.2-530.0) and close (OR 6.4, 95 % CI 3.0-13.6) invasive margin, and time period (OR 0.5, 95 % CI 0.3-0.9 for post vs. pre) as independently associated with reexcision.
conclusionsOverall reexcision rates declined significantly after guideline adoption. Close invasive margins were associated with higher rates of reexcision than negative invasive margins in both time periods; however, the effect diminished in the postguideline adoption period. Thus, we expect continued decline in reexcision rates as adherence to guidelines becomes more uniform.
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