ArticleCancer management and research2019
Positive or close margins: reoperation rate and second conservative resection or total mastectomy?
Article in Cancer management and research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- The role of simulation in training breast surgeons: a systematic review.Annals of the Royal College of Surgeons of England · 2021Pooled it
- Factors associated with discordance between pathological and radiological tumor size and risk of re-excision in breast-conserving surgery: a post-hoc analysis within a randomized trial.Breast cancer research and treatment · 2026Trial
- Preliminary study demonstrating cancer cells detection at the margins of whole glioblastoma specimens with Raman spectroscopy imaging.Scientific reports · 2025Article
- Article
- Clinicopathological Predictors of Positive Resection Margins in Breast-Conserving Surgery.Annals of surgical oncology · 2024Observational
- An intraoperative nomogram for predicting secondary margin positivity in breast conserving surgery utilizing frozen section analysis.Frontiers in oncology · 2024Article
- Intratumoral and peritumoral radiomics based on dynamic contrast-enhanced MRI for preoperative prediction of intraductal component in invasive breast cancer.European radiology · 2022Article
- Article
- Tumor margins that lead to reoperation in breast cancer: A retrospective register study of 4,489 patients.Journal of surgical oncology · 2022Article
- Triple-negative breast cancer: current treatment strategies and factors of negative prognosis.Journal of medicine and life · 2022Review
- Neoadjuvant Chemotherapy for Breast Cancer: Evolution of Clinical Practice in a French Cancer Center Over 16 Years and Pathologic Response Rates According to Tumor Subtypes and Clinical Tumor Size: Retrospective Cohort Study.Journal of surgery and research · 2022Article
- Radiological Underestimation of Tumor Size Influences the Success Rate of Re-Excision after Breast-conserving Surgery.European journal of breast health · 2021Article
- Validated prediction model for positive resection margins in breast-conserving surgery based exclusively on preoperative data.BJS open · 2021Article
- Predictors of Reexcision following Breast-Conserving Surgery for Ductal Carcinoma In Situ.Annals of surgical oncology · 2021Article
- Mastectomy with immediate breast reconstruction: Results of a mono-centric 4-years cohort.Annals of medicine and surgery (2012) · 2021Article
- The Value of Repeated Breast Surgery as a Quality Indicator in Breast Cancer Care.Annals of surgical oncology · 2021Article
- Methylene Blue-Current Knowledge, Fluorescent Properties, and Its Future Use.Journal of clinical medicine · 2020Review
- Lymphedema Signs, Symptoms, and Diagnosis in Women Who Are in Minority and Low-Income Groups and Have Survived Breast Cancer.Physical therapy · 2020Observational
- Success rates of re-excision after positive margins for invasive lobular carcinoma of the breast.NPJ breast cancer · 2019Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionReoperation after breast-conserving surgery (BCS) could be proposed for positive or close margins. Reoperation type, re-excision or mastectomy, depends on several factors in relation to patient's and tumor's characteristics. We have analyzed our breast cancer (BC) database in order to determine second and third attempts for BCS and mastectomy rates, as well as associated factors for type of surgery.
methodsAll patients with BCS between 1995 and 2017 were included. Patient's characteristics, pathologic results, and treatments were analyzed. Reoperation rate, type of reoperation, second reoperation, and associated factors of reoperation, mastectomy, and third intervention were determined. Three periods were determined: P1-P3.
resultsWe analyzed 10,761 patients: 1,161 with ductal carcinoma in situ (DCIS) and 9,600 with invasive BC. The reoperation rate was 41.4% for DCIS and 28.0% for invasive BC. Using multivariate analysis, we identified tumor size >20 mm as being a risk factor for reoperation, whereas age >50 years, P2-3, and some localization decreased reoperation rates. For invasive BC, age >40 years, triple-negative tumors, neoadjuvant chemotherapy, and noncentral tumors decreased reoperation rates and lobular tumor, multifocal tumors, lymphovascular invasion, DCIS component, and Her2-positive tumors increased reoperation rates. For patients requiring reoperation, re-excision was performed in 48.1% (1,523/3,168) and mastectomy was required after first re-excision in 13.46% (205/1,523). For DCIS, mastectomy rates were higher for grade 2 and tumor ≥20 mm. For invasive BC, mastectomy rates were higher for lobular, multifocal, ≥20 mm, Her2-positive tumors and diffuse positive margins and lower for age >50 years and during the last period. Even if interval time between surgery and adjuvant treatments was higher for patients with reoperation, survival rates were not different between patients with and without reoperation.
conclusionA decrease in reoperation and mastectomy rates had been reported with several associated factors. A third intervention with mastectomy was required in 13.5% of patients. This information should be done in case of reoperation.
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