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Langenbeck's Archives of Surgery

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01-03-2013 | Original Article

Predictors of margin status after breast-conserving operations in an underscreened population

Authors: Rozbeh Torabi, Chiu-Hsieh Hsu, Prahladbhai N. Patel, Harikrishna Dave, Marcia E. Bouton, Ian K. Komenaka

Published in: Langenbeck's Archives of Surgery | Issue 3/2013

Abstract

Purpose

Negative margins after lumpectomy remain a prominent issue in breast surgery. The current study was performed to evaluate patient-related variables that affect risk for positive margins in an underscreened population.

Methods

A retrospective review was performed of all patients who underwent breast-conserving operations from 2001 to 2010. Sociodemographic, clinical, and treatment variables were evaluated. One millimeter from tumor to inked margin was considered a negative margin. Univariate and multivariate analyses were performed to identify variables which affect margin status after a lumpectomy.

Results

Over the time period evaluated, 69 patients had positive margins (31 %) and 155 (69 %) had negative margins. Overall use of screening mammography was poor (36 %). In unadjusted analysis, patients with positive margins were less likely to have undergone screening mammography (p = 0.003) and presented with a palpable mass (p = 0.01). Histopathologic variables which predicted increased risk for positive margins included larger pathologic size, greater number of pathologically involved lymph nodes, higher pathologic stage, presence of lymphovascular invasion (LVI) and extensive intraductal component (EIC), p < 0.05. In multivariate analysis, clinical stage, poor histologic grade, LVI, and EIC were associated with positive margins (p < 0.05). By contrast, use of preoperative chemotherapy was associated with attaining negative margins (p < 0.05).

Conclusions

Factors associated with positive margins after lumpectomy included poor histologic grade, LVI, and EIC. Use of preoperative chemotherapy was the strongest independent predictor of lower risk for positive margins.

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Title: Predictors of margin status after breast-conserving operations in an underscreened population
Authors: Rozbeh Torabi
Chiu-Hsieh Hsu
Prahladbhai N. Patel
Harikrishna Dave
Marcia E. Bouton
Ian K. Komenaka
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 3/2013
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-012-1023-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predictors of margin status after breast-conserving operations in an underscreened population

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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