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Disease recurrence in patients undergoing mastectomy for ductal carcinoma in situ.
Breast Cancer Res Treat
November 2024
Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Purpose: With DCIS incidence on the rise, up to 30% of patients undergo mastectomy for Ductal carcinoma in situ (DCIS) (Nash and Hwang, in: Ann Surg Oncol 30(6):3206-3214, 2023). Local recurrence rates after mastectomy for DCIS are reportedly low, but risk factors for recurrence are not known (Kim et al., in: J Cancer Res Ther 16(6):1197-1202, 2020).
View Article and Find Full Text PDFReimagining Deintensification for Low-Risk Breast Cancer.
JCO Oncol Pract
October 2024
Breast Center, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH.
As outcomes for low-risk breast cancer continue to improve, research and clinical paradigms are increasingly focused on appropriate deintensification with the goal of improving the therapeutic ratio of breast cancer treatment. These deintensification approaches span across disciplines including breast surgery, radiation therapy, and systemic therapy. With regard to breast surgery, studies have continued to push deintensification when it comes to surgical margins with breast conservation, reducing re-excision rates, whereas deintensification of axillary surgery has reduced the rates of axillary lymph node dissection and increasingly the need for any axillary surgery, including sentinel lymph node biopsy for low-risk patients.
View Article and Find Full Text PDFIdentifying Factors Predicting Margin Status After Mastectomy.
Ann Surg Oncol
December 2024
The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
Introduction: A positive margin after mastectomy increases the risk of breast cancer recurrence and the morbidity associated with re-excision or chest wall irradiation. This study aimed to identify factors that may predict margin status after mastectomy.
Methods: Women with Tis-T3 breast cancers who underwent mastectomy from 2014 to 2020 were retrospectively analyzed.
Evaluating the Effect of MarginProbe Use on Re-excisions After Partial Mastectomy: A Single-Institution Analysis.
Ann Surg Oncol
November 2024
Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Background: Breast conservation therapy is a widely accepted approach in treating breast cancer, yet the average re-excision rates are approximately 25% despite surgical advancements. The Food and Drug Administration (FDA)-approved MarginProbe device uses radiofrequency spectroscopy for intraoperative margin assessment, potentially reducing re-excision rates. This study evaluated the effectiveness of MarginProbe in reducing re-excisions compared with standard of care (SOC).
View Article and Find Full Text PDFIs the Number or Proximity of Margins Less than 2 mm Associated with an Increased Mastectomy Rate in Patients Attempting Breast Conservation Therapy for Ductal Carcinoma In Situ?
Ann Surg Oncol
October 2024
Department of Surgery, Division of Breast Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Article Synopsis
- * Among 208 patients reviewed, those with two or more close/positive margins had a significantly higher mastectomy rate (20%) compared to those with one close/positive margin (7%).
- * The findings suggest that while close/positive margins increase the likelihood of needing a mastectomy, having opposing close margins does not affect this rate and most were managed successfully with re-excision.
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