ArticleBreast cancer research and treatment2017
Omitting re-excision for focally positive margins after breast-conserving surgery does not impair disease-free and overall survival.
Article in Breast cancer research and treatment, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Effect of re-excision on local recurrence in patients with involved or close margins after upfront breast-conserving surgery: a systematic review and meta-analysis.World journal of surgical oncology · 2025Pooled it
- The Japanese breast cancer society clinical practice guidelines for pathological diagnosis of breast cancer, 2022 edition.Breast cancer (Tokyo, Japan) · 2024Guideline
- Margin status after breast-conserving surgery for breast cancer in the Netherlands from 2009 to 2022.BJS open · 2026Article
- Article
- Reoperation Versus Dose-Escalated Radiotherapy for Ductal CarcinomaJournal of breast cancer · 2025Article
- Article
- Positive margins after breast-conserving surgery: is it possible to hang up the scalpel in the era of precision medicine?Updates in surgery · 2025Article
- Vacuum-assisted excision: one-step approach to the diagnosis and percutaneous treatment of small early breast cancer (the VAE-BREAST 01 study protocol).Frontiers in oncology · 2025Article
- Ex vivo fluorescence-guided resection margin assessment in breast cancer surgery using a topically applied, cathepsin-activatable imaging agent.Pharmacological research · 2024Article
- Escalation and De-Escalation of Adjuvant Radiotherapy in Early Breast Cancer: Strategies for Risk-Adapted Optimization.Cancers · 2024Review
- Breast surgery after neoadjuvant chemotherapy in patients with lobular carcinoma: surgical and oncologic outcome.Breast cancer research and treatment · 2024Article
- Residual Risk of Ipsilateral Tumor Recurrence in Patients Who Achieved Clear Lumpectomy Margins After Repeated Resection.Journal of breast cancer · 2023Article
- Comparing quality of breast cancer care in the Netherlands and Norway by federated propensity score analytics.Breast cancer research and treatment · 2023Article
- Immediate or delayed oncoplastic surgery after breast conserving surgery at the Netherlands Cancer Institute: a cohort study of 251 cases.Breast cancer research and treatment · 2023Article
- Cysteine Cathepsins in Breast Cancer: Promising Targets for Fluorescence-Guided Surgery.Molecular imaging and biology · 2023Review
- Potential role of vacuum-assisted procedures in resecting breast cancers and highlighting selection criteria to support future trials.Frontiers in oncology · 2023Article
- Radiological Underestimation of Tumor Size Influences the Success Rate of Re-Excision after Breast-conserving Surgery.European journal of breast health · 2021Article
- The Impact of Preoperative Breast MRI on Surgical Margin Status in Breast Cancer Patients Recalled at Biennial Screening Mammography: An Observational Cohort Study.Annals of surgical oncology · 2021Observational
- The Value of Repeated Breast Surgery as a Quality Indicator in Breast Cancer Care.Annals of surgical oncology · 2021Article
- Minimally invasive breast cancer excision using the breast lesion excision system under ultrasound guidance.Breast cancer research and treatment · 2020Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn contrast to other countries, the Dutch breast cancer guideline does not recommend re-excision for focally positive margins after breast-conserving surgery (BCS) in invasive tumor and does recommend whole-breast irradiation including boost. We investigated whether omitting re-excision as compared to performing re-excision affects prognosis with a retrospective population-based cohort study.
methodsThe total cohort included 32,119 women with primary BCS for T1-T3 breast cancer diagnosed between 2003 and 2008 from the nationwide Netherlands cancer registry. The subcohort included 10,433 patients in whom the resection margins were registered. Outcome measures were 5-year ipsilateral breast tumor recurrence (IBTR) rate, 5-year disease-free survival (DFS) rate, and 10-year overall survival (OS) rate.
resultsIn the total cohort, 25,878 (80.6%) did not have re-excision, 2368 (7.4%) had re-excision by BCS, and 3873 (12.1%) had re-excision by mastectomy. Five-year IBTR rates were 2.1, 2.8, and 2.9%, respectively (p = 0.001). In the subcohort, 7820 (75.0%) had negative margins without re-excision, 492 (4.7%) had focally positive margins without re-excision, 586 (5.6%) had focally positive margins and underwent re-excision, and 1535 (14.7%) had extensively positive margins and underwent re-excision. Five-year IBTR rate was 2.3, 2.9, 1.1, and 2.9%, respectively (p = 0.099). Compared to omitting re-excision, performing re-excision for focally positive margins was associated with lower risk of IBTR (adjusted HR 0.30, 95% CI 0.11-0.82), but not with DFS (adjusted HR 0.83 95% CI 0.59-1.17) nor with OS (adjusted HR 1.17 95% CI 0.87-1.59).
conclusionOmitting re-excision in breast cancer patients for focally positive margins after BCS does not impair DFS and OS, provided that whole-breast irradiation including boost is given.
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