Evidence map›Paper›PMID 40281617›Full record

SynthesisWorld journal of surgical oncology2025

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.

Noam Weiner, Yaron Niv, Eran Sharon

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Immunohistochemical predictors of local recurrence in breast carcinoma: development and sensitivity validation of an IHC-based risk score.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie
    Article
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

3 authors.

Noam WeinerBreast Surgery Unit, Department of Surgery, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., Petach Tikva, 4941492, Israel. wrnoam@gmail.com.
Yaron NivAdelson Faculty of Medicine, Ariel University, Ariel, Israel.
Eran SharonBreast Surgery Unit, Department of Surgery, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., Petach Tikva, 4941492, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInvolved margins after breast-conserving surgery are associated with increased risk of local recurrence. A systematic search and meta-analysis was conducted to investigate the still-unclear role of re-excision in reducing this risk.

methodsA systematic search of the English-language literature up to May 31, 2024, was performed using PubMed and Embase databases. Studies that met the following criteria were included in the meta-analysis: available full data, patients with breast cancer, involved or close margins after breast-conserving surgery, and comparison of local recurrence rates between patients who underwent re-excision and those who did not. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated using the random effects model. Bias risk was assessed with Begg-Mazumdar and Egger tests.

resultsEight papers and 13 datasets were included in the analysis. Studies differed by sample selection: inclusion of patients with close margins and of both patients with invasive cancer and carcinoma in situ. Of the total 3728 patients, 1897 underwent re-excision and 1831 did not. The mean OR of local recurrence after re-excision was 1.034 (95% CI 0.656-1.629), with a p-value of 0.885. The mean OR of local recurrence after re-excision in patients with DCIS was 2.065 (95% CI 0.96 - 4.442), with a p-value of 0.063, and in patients with 10-years follow-up the mean OR was 1.47 (95% CI 0.75 - 2.86) with a p-value of 0.26.

conclusionThe local recurrence rate in this study did not differ between patients with involved or close margins after breast-conserving surgery who had or did not have additional surgery. The absence of local control effect remained in those with longer follow-up. A trend toward an increased risk of local recurrence was observed in patients with carcinoma in situ who underwent re-excision; however, this finding did not reach statistical significance. Thus, we recommend against routine re-excision and suggest it should be carried out only in selected cases, after thorough discussion of a multidisciplinary team.

Indexed as

Breast NeoplasmsMargins of ExcisionMastectomy, SegmentalNeoplasm Recurrence, LocalReoperationFemaleHumansPrognosisBreast cancerMeta-analysisRecurrenceRe-excisionSystematic review

Identifiers

PMID40281617
PMCPMC12023596

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.