Evidence map›Paper›PMID 41351691›Full record

ArticleAnnals of surgical oncology2026

Factors Associated With Residual Disease on Re-Excision Specimens After Breast-Conserving Surgery for Breast Cancer.

Kyle Lee, Angela Pallesi, Betsy J Valdez, Douglas A Hanes, Estela Samuels, Stacey Stern, Nicketti M Handy, Crystal E Fancher, Javier I J Orozco, Janie G Grumley

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Kyle LeeSaint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
Angela PallesiSaint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
Betsy J ValdezSaint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
Douglas A HanesCenter for Cardiovascular Analytics, Research and Data Science, Providence Research Network, Portland, OR, USA.
Estela SamuelsSaint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
Stacey SternSaint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
Nicketti M HandySaint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
Crystal E FancherSaint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
Javier I J Orozco *Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
Janie G Grumley *Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA. janie.grumley@providence.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAfter breast-conserving surgery (BCS) for early-stage breast cancer, re-excision rates for positive or close margins remain high, although most re-excisions show no residual disease. This study aimed to identify clinicopathologic factors associated with residual disease to guide re-excision decisions.

methodsThe study evaluated women with ductal carcinoma in situ (DCIS) or invasive breast cancer who underwent BCS and re-excision for positive or close margins from 2018 to 2024 at the Saint John's Cancer Institute. The association between clinical-pathologic variables and residual disease was evaluated by multivariable logistic regression.

resultsOf 932 patients treated with BCS, 184 (19.7 %) underwent re-excision for positive or close margins. Residual disease was found in 54 (29 %) patients, most commonly DCIS (n = 36, 66.7 %). In the multivariable analysis, residual disease was associated with three or more positive margins (odds ratio [OR], 9.87; 95 % confidence interval [CI], 3.23-30.17), DCIS at the margin (OR, 7.4; 95 % CI, 1.56-35.16), PR negativity (OR, 4.06; 95 % CI, 1.26-13.12), and mammographic microcalcifications (OR, 3.0; 95 % CI, 1.17-7.69). Conversely, reduced risk was associated with age ≥60 years (OR, 0.07; 95 % CI, 0.01-0.46), invasive carcinoma with extensive intraductal component (EIC: OR, 0.15; 95 % CI, 0.03-0.66), and pure DCIS (OR, 0.14; 95 % CI, 0.03-0.63).

conclusionsResidual disease was found in fewer than one third of re-excision specimens. Factors reflecting margin burden and tumor biology, especially the number of positive margins, DCIS involvement of margin, and PR-negativity, were associated with residual malignancy, whereas EIC and older age were associated with a lower likelihood of residual disease. These findings support a risk-adapted, individualized approach to re-excision after BCS to minimize unnecessary surgery.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, Intraductal, NoninfiltratingMastectomy, SegmentalNeoplasm, ResidualReoperationAdultAgedFemaleFollow-Up StudiesHumansMargins of ExcisionMiddle AgedPrognosisRetrospective StudiesBreast-conserving surgeryBreast neoplasmMargin re-excisionResidual diseaseSurgical margins

Identifiers

PMID41351691

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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.