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26-07-2023 | Breast Cancer | Breast Oncology

Does Non-Classic Lobular Carcinoma In Situ at the Lumpectomy Margin Increase Local Recurrence?

Authors: Anna C. Beck, MD, Solange Bayard, MD, George Plitas, MD, Varadan Sevilimedu, MBBS, DrPH, M. Gabriela Kuba, MD, Paula Garcia, MHA, Monica Morrow, MD, Audree B. Tadros, MD, MPH

Published in: Annals of Surgical Oncology | Issue 10/2023

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Abstract

Background

The clinical significance of nonclassic, lobular carcinoma in situ (NC-LCIS) at the surgical margin of excisions for invasive cancer is unknown. We sought to determine whether NC-LCIS at or near the margin in the setting of a concurrent invasive carcinoma is associated with risk of ipsilateral breast tumor recurrence (IBTR) and locoregional recurrence (LRR).

Methods

Patients with stage 0-III breast cancer and NC-LCIS who underwent lumpectomy between January 2010 and January 2022 at a single institution were retrospectively identified. NC-LCIS margins were stratified as <2 mm, ≥2 mm, or within shave margin. Rates of IBTR and LRR were examined.

Results

A total of 511 female patients (median age 60 years [interquartile range (IQR) 52–69]) with NC-LCIS and an associated ipsilateral breast cancer with a median follow-up of 3.4 years (IQR 2.0–5.9) were identified. Final margins for NC-LCIS were ≥2 mm in 348 patients (68%), <2 mm in 37 (7.2%), and within shave margin in 126 (24.6%). Crude incidence of IBTR was 3.3% (n = 17) and that of LRR was 4.9% (n = 25). There was no difference in the crude rate of IBTR by NC-LCIS margin status (IBTR rate: 3.7% ≥2 mm, 0% <2 mm, 3.2% within shave margin, p = 0.8) nor in LRR (LRR rate: 4.9% ≥2 mm, 2.7% <2 mm, 5.6% within shave margin, p = 0.9).

Conclusions

For completely excised invasive breast cancers associated with NC-LCIS, extent of margin width for NC-LCIS was not associated with a difference in IBTR or LRR. These data suggest that the decision to perform reexcision of margin after lumpectomy should be driven by the invasive cancer, rather than the NC-LCIS margin.
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Metadata
Title
Does Non-Classic Lobular Carcinoma In Situ at the Lumpectomy Margin Increase Local Recurrence?
Authors
Anna C. Beck, MD
Solange Bayard, MD
George Plitas, MD
Varadan Sevilimedu, MBBS, DrPH
M. Gabriela Kuba, MD
Paula Garcia, MHA
Monica Morrow, MD
Audree B. Tadros, MD, MPH
Publication date
26-07-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 10/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-13899-1

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