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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2019

01-11-2019 | Mastectomy | Breast Oncology

Editorial: Applying Margin Consensus Guidelines to Invasive Lobular Carcinoma of the Breast

Author: Rita A. Mukhtar, MD

Published in: Annals of Surgical Oncology | Issue 12/2019

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Excerpt

In their recent study, “Was reexcision less frequent in patients with lobular breast cancer after publication of the SSO-ASTRO margin guidelines,” Mamtani et al. show that women with invasive lobular carcinoma (ILC) indeed had lower rates of second surgery after adoption of new consensus guidelines at their center.1 Before guideline adoption, 31.4% of patients in their large series of ILC had either reexcision or completion mastectomy after breast-conserving surgery. After guideline implementation in 2014, this second surgery rate decreased to 23.1%, a drop of similar magnitude to that seen in patients with invasive ductal carcinoma (IDC). A reduction in reexcisions was not necessarily expected for the following reasons: many surgeons have questioned the safety of narrow margins in ILC because of its growth pattern; additionally, there is a paucity of data on outcomes of narrow margins in this tumor type. However, women with ILC have such high rates of reexcisions and completion mastectomies that these findings could represent a meaningful improvement in their care. …
Literature
1.
Mamtani AZ, Rosenberger E, Stempel L, et al. Was re-excision less frequent in patients with lobular breast cancer after publication of the SSO-ASTRO margin guidelines? Ann Surg Oncol. 2019 (in press).
2.
Behm EC, Beckmann KR, Dahlstrom JE, Zhang Y, Cho C, Stuart-Harris R, et al. Surgical margins and risk of locoregional recurrence in invasive breast cancer: an analysis of 10-year data from the Breast Cancer Treatment Quality Assurance Project. Breast. 2013;22(5):839–44.CrossRefPubMed
3.
Havel L, Naik H, Ramirez L, Morrow M, Landercasper J, et al. Impact of the SSO-ASTRO margin guideline on rates of re-excision after lumpectomy for breast cancer: a meta-analysis. Ann Surg Oncol. 2019;26(5):1238–44.CrossRefPubMed
4.
Houssami N, Macaskill P, Marinovich ML, Morrow M, et al. The association of surgical margins and local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy: a meta-analysis. Ann Surg Oncol. 2014;21(3):717–30.CrossRefPubMedPubMedCentral
5.
Chung A, Gangi A, Amersi F, Bose S, Zhang X, Giuliano A, et al. Impact of Consensus Guidelines by the Society of Surgical Oncology and the American Society for Radiation Oncology on margins for breast-conserving surgery in stages 1 and 2 invasive breast cancer. Ann Surg Oncol. 2015;22(Suppl 3):S422–7.CrossRef
6.
Monaghan A, Chapinal N, Hughes L, Baliski C, et al. Impact of SSO-ASTRO margin guidelines on reoperation rates following breast-conserving surgery. Am J Surg. 2019;217(5):862-7.CrossRefPubMed
7.
Rosenberger LH, Mamtani A, Fuzesi S, Stempel M, Eaton A, Morrow M, et al. Early adoption of the SSO-ASTRO Consensus Guidelines on margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive breast cancer: initial experience from Memorial Sloan Kettering Cancer Center. Ann Surg Oncol. 2016;23(10):3239–46.CrossRefPubMedPubMedCentral
8.
Schulman AM, Mirrielees JA, Leverson G, Landercasper J, Greenberg C, Wilke LG, et al. Reexcision surgery for breast cancer: an analysis of the American Society of Breast Surgeons (ASBrS) Mastery(SM) Database Following the SSO-ASTRO “No Ink on Tumor” Guidelines. Ann Surg Oncol. 2017;24(1):52–8.CrossRefPubMed
9.
10.
Mamtani A, King TA. Lobular breast cancer: different disease, different algorithms? Surg Oncol Clin N Am. 2018;27(1):81–94.CrossRefPubMed
11.
Houvenaeghel G, Tallet A, Jalaguier-Coudray A, Cohen M, Bannier M, Jauffret-Fara C, et al. Is breast conservative surgery a reasonable option in multifocal or multicentric tumors? World J Clin Oncol. 2016;7(2):234–42.CrossRefPubMedPubMedCentral
12.
Hussien M, Lioe TF, Finnegan J, Spence RA, et al. Surgical treatment for invasive lobular carcinoma of the breast. Breast. 2003;12(1):23–35.CrossRefPubMed
13.
Galimberti V, Maisonneuve P, Rotmensz N, Viale G, Sangalli C, Sargenti M, et al. Influence of margin status on outcomes in lobular carcinoma: experience of the European Institute of Oncology. Ann Surg. 2011;253(3):580–4.CrossRefPubMed
14.
DeSnyder SM, Hunt KK, Smith BD, Moran MS, Klimberg S, Lucci A, et al. Assessment of practice patterns following publication of the SSO-ASTRO Consensus Guideline on margins for breast-conserving therapy in stage I and II invasive breast cancer. Ann Surg Oncol. 2015;22(10):3250–6.CrossRefPubMedPubMedCentral
15.
Braunstein LZ, Brock JE, Chen YH, Truong L, Russo AL, Arvold ND, et al. Invasive lobular carcinoma of the breast: local recurrence after breast-conserving therapy by subtype approximation and surgical margin. Breast Cancer Res Treat. 2015;149(2):555–64.CrossRefPubMed
16.
Sagara Y, Barry WT, Mallory MA, Vaz-Luis I, Aydogan F, Brock JE, et al. Surgical options and locoregional recurrence in patients diagnosed with invasive lobular carcinoma of the breast. Ann Surg Oncol. 2015;22(13):4280–6.CrossRefPubMedPubMedCentral
Metadata
Title
Editorial: Applying Margin Consensus Guidelines to Invasive Lobular Carcinoma of the Breast
Author
Rita A. Mukhtar, MD
Publication date
01-11-2019
Publisher
Springer International Publishing
Keyword
Mastectomy
Published in
Annals of Surgical Oncology / Issue 12/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07761-6

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