2023, Number 12
Surgical margins in shaved cavity in quadrantectomy for breast cancer in Medellín, Colombia
Language: Spanish
References: 19
Page: 869-877
PDF size: 204.72 Kb.
ABSTRACT
Objectives: To determine the usefulness of quadrantectomy cavity shaving for breast cancer in reducing reoperation and to explore its associated factors and describe sociodemographic and clinical data of the patients.Materials and Methods: A retrospective, descriptive, retrospective cohort study conducted between January 1, 2017 and December 31, 2018 in patients older than 18 years with histologic diagnosis of invasive and in situ breast cancer who underwent quadrantectomy with shaving of all cavity margins. This is the registry of patients of a surgeon in Medellin, Colombia. Demographic, clinical, and paraclinical data were collected and analyzed using descriptive statistics.
Results: 194 patients with a mean age of 61.6 years were included. The margins were negative in 85.6% (n = 161) and positive in 14.4% (n = 28). The shaved cavity was involved in 16% (n = 31), no reintervention was required in 95.9% (n = 186), and 4.1% (n = 8) underwent reintervention. The reduction in reoperation was 10.3% (n=20). Factors associated with positive margins were: harpoon marking (OR = 1.19; 95%CI: 1.07-1.32; p = 0.04), multifocal tumor (OR = 3.95; 95%CI: 2.29-6.81; p = 0.00), affected shave (OR = 3.26; 95%CI: 1.75-6.04). No increased risk of local recurrence was found between groups (OR = 0.85; 95%CI: 0.80-0.90; p = 0.35).
Conclusions: Shaving all margins of the quadrantectomy cavity was associated with a lower rate of involved margins and fewer reinterventions. Factors associated with positive margins were: harpoon marking, multifocal tumor, and shave damage; there was no increased risk of recurrence.
REFERENCES
Global Cancer Statistics 2020: GLOBOCAN Estimatesof Incidence and Mortality Worldwide for 36 Cancersin 185 Countries. https://gco.iarc.fr/today/onlineanalysis-multi-bars?v=2020&mode=cancer&mode_population=countries&population=900&populations=900&key=total&sex=2&cancer=39&type=0&statistic=5&prevalence=0&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=14&nb_items=10&group_cancer=1&include_nmsc=0&include_nmsc_other=1&type_multiple=%257B%2522inc%2522% 253Atrue%252C%2522mort%2522%253Atrue%252C%2522prev%2522%253Afalse%257D&orientation=horizontal&type_sort=0&type_nb_items=%257B%2522top%2522%253Atrue%252C%2522bottom%2522%253Afalse%257D
Buchholz TA, Somerfield MR, Griggs JJ, El-Eid S, HammondMEH, Lyman GH, et al. Margins for breast-conservingsurgery with whole-breast irradiation in stage I and IIinvasive breast cancer: American Society of Clinical OncologyEndorsement of the Society of Surgical Oncology/American Society for Radiation Oncology Consensus Guideline.J Clin Oncol 2014; 32 (14): 1502-6. doi:10.1200/JCO.2014.55.1572
Park CC, Mitsumori M, Nixon A, Recht A, Connolly J, GelmanR, et al. Outcome at 8 years after breast-conservingsurgery and radiation therapy for invasive breast cancer:influence of margin status and systemic therapy on localrecurrence. J Clin Oncol 2000; 18 (8): 1668-75. doi:10.1200/JCO.2000.18.8.1668
Moran MS, Schnitt SJ, Giuliano AE, Harris JR, Khan SA, HortonJ, et al. Society of Surgical Oncology -American Societyfor Radiation Oncology Consensus Guideline on Margins forbreast-conserving surgery with whole-breast irradiation instages I and II invasive breast cancer. Ann Surg Oncol 2014;21 (3): 704-16. doi:10.1245/s10434-014-3481-4
Dupont E, Tsangaris T, Garcia-Cantu C, Howard-McNattM, Chiba A, Berger AC, et al. Resection of cavity shavemargins in stage 0-II breast cancer patients undergoingbreast conserving surgery: a prospective multicenter randomizedcontrolled trial. Ann Surg 2021; 273 (5): 876-81.doi:10.1097/SLA.0000000000003449.