Is the Number or Proximity of Margins Less than 2 mm Associated with an Increased Mastectomy Rate in Patients Attempting Breast Conservation Therapy for Ductal Carcinoma In Situ?

Leslie R Elmore, Erin M Bayley, Beth Z Clark, Priscilla F McAuliffe, Michael S Cowher

Abstract read

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Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed

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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

Risk factors for conversion to mastectomy due to positive margins in early breast cancer patients when choosing breast-conserving surgery: a retrospective cohort study.Frontiers in oncology · 2026
Article

4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Leslie R ElmoreDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Erin M BayleyDepartment of Surgery, Division of Breast Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Beth Z ClarkDepartment of Pathology, Division of Breast and Gynecologic Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Priscilla F McAuliffeDepartment of Surgery, Division of Breast Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Michael S CowherDepartment of Surgery, Division of Breast Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. cowherms2@upmc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConsensus guidelines recommend ≥ 2 mm margins in patients undergoing partial mastectomy (PM) for ductal carcinoma in situ (DCIS). It is unknown whether the number or proximity of margins less than 2 mm is associated with an increased mastectomy rate in patients attempting breast conservation therapy (BCT) for DCIS. The aim of this study is to examine this relationship. PATIENTS AND

methodsAn institutional database review identified 208 patients with DCIS who underwent PM at a tertiary referral center and community hospitals from July 2020 to June 2023. Patients with a history of breast cancer, previous surgery for breast cancer, ipsilateral invasive carcinoma, papillary carcinoma, Paget's disease, more lobular carcinoma in situ (LCIS) than DCIS present, initial mastectomy, no DCIS present, routine shave margins (of all vectors), and ≥ 2 mm margins of all six vectors were excluded. Selective intraoperative margin re-excisions were included.

resultsA total of 208 patients who met inclusion criteria were retrospectively reviewed. 122 (25%) had one close/positive (< 2 mm) margin and 86 (18%) had two or more close/positive margins. Of the patients with one close/positive margin, 7% (9/122) eventually underwent mastectomy. Of the patients with two or more close/positive margins, 20% (17/86) eventually underwent mastectomy. Overall, no patients with opposing margins underwent mastectomy.

conclusionsPatients undergoing PM for DCIS have a mastectomy rate that is increased threefold, with two or more close/positive margins at initial PM, when compared with those with only one close/positive margin. The presence of opposing close/positive margins at initial PM did not increase the mastectomy rate and most were cleared with re-excision.

Indexed as

Breast NeoplasmsCarcinoma, Intraductal, NoninfiltratingMargins of ExcisionMastectomy, SegmentalAdultAgedCarcinoma, Ductal, BreastFemaleFollow-Up StudiesHumansMastectomyMiddle AgedPrognosisRetrospective Studies2 mm marginBreast conservation therapyDCISDuctal carcinoma in situMastectomyPartial mastectomyProximity

Identifiers

PMID39085550

DOI10.1007/s10549-013-2652-5

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