Evidence map›Paper›PMID 40272667›Full record

SynthesisAnnals of surgical oncology2025

Positive Margin Rates After Breast-Conserving Surgery by Histologic Subtype: A Systematic Review and Meta-analysis Evaluating the Impact of Oncoplastic Surgery.

Kayla M Switalla, Israel O Falade, Astrid Quirarte, Molly Baxter, Mandeep Kaur, Rita A Sakr, Giovanni Corso, Rita A Mukhtar

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kayla M SwitallaDepartment of Surgery, UCSF Breast Care Center, University of California San Francisco, San Francisco, CA, USA.
Israel O FaladeSchool of Medicine, University of California San Francisco, San Francisco, CA, USA.
Astrid QuirarteDepartment of Surgery, UCSF Breast Care Center, University of California San Francisco, San Francisco, CA, USA.
Molly BaxterDepartment of Surgery, UCSF Breast Care Center, University of California San Francisco, San Francisco, CA, USA.
Mandeep KaurSchool of Medicine, University of California San Francisco, San Francisco, CA, USA.
Rita A SakrDepartment of Breast Oncoplastic Surgery, Emirates Hospital Group, Dubai, United Arab Emirates.
Giovanni CorsoDepartment of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
Rita A MukhtarDepartment of Surgery, UCSF Breast Care Center, University of California San Francisco, San Francisco, CA, USA. rita.mukhtar@ucsf.edu.

Funding

Identifying responders to chemotherapy in invasive lobular carcinoma of the breast: development of a multivariable clinical prediction toolK08CA256047 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MUKHTAR, RITA · 2021 to 2025
$1.3M
CCR NIH HHS K08CA256047NCI NIH HHS K08 CA256047
6 · The paper itself

Abstract

backgroundInvasive lobular carcinoma (ILC), the second most common histologic subtype of breast cancer, has a higher risk of positive surgical margins than invasive ductal carcinoma (IDC). Whether this risk persists for patients undergoing breast-conserving surgery (BCS) with oncoplastic approaches remains unclear. We conducted a systematic review and meta-analysis to assess positive margins following oncoplastic BCS by histologic subtype and evaluate the impact of oncoplastic surgery on positive margins in ILC.

methodsWe systematically searched the literature for articles reporting positive margin rates after oncoplastic BCS in ILC patients. Relative risks (RR) were log transformed and displayed with forest plots.

resultsEight studies, encompassing 754 ILC patients undergoing BCS (338 with oncoplastic surgery), were included. The pooled positive margin rate for ILC patients undergoing oncoplastic surgery was 31% (95% confidence interval [CI] 21-40%). Patients with ILC had a significantly higher RR for positive margins after oncoplastic BCS compared with IDC (RR 3.4, 95% CI 1.5-7.4). However, for ILC patients with larger tumors, oncoplastic BCS was associated with a significantly lower RR for positive margins compared with standard BCS (RR 0.5, 95% CI 0.3-0.9).

conclusionsInvasive lobular carcinoma patients undergoing oncoplastic BCS have higher positive margin risks than IDC patients, underscoring the need for improved preoperative imaging and systemic therapies. However, the addition of oncoplastic surgery to BCS reduces positive margin rates compared with standard BCS in ILC patients, particularly for larger tumors. These findings highlight the role of oncoplastic surgery as an important technique to optimize outcomes for those at high risk of positive margins.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, LobularMammaplastyMargins of ExcisionMastectomy, SegmentalFemaleHumansPrognosisBreast-conserving surgery (BCS)Invasive lobular carcinomaMeta-analysisOncoplastic surgeryPositive margins

Identifiers

PMID40272667
PMCPMC12129873

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.