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Fernandez-Pacheco, Miriam ; Gerken, Michael ; Ortmann, Olaf ; Ignatov, Atanas ; Klinkhammer-Schalke, Monika ; Hatzipanagiotou, Maria Eleni ; Inwald, Elisabeth C.

Impact of cavity shaving on residual tumor rates in patients with primary invasive carcinoma and carcinoma in situ in breast conserving surgery

Fernandez-Pacheco, Miriam , Gerken, Michael, Ortmann, Olaf , Ignatov, Atanas , Klinkhammer-Schalke, Monika, Hatzipanagiotou, Maria Eleni und Inwald, Elisabeth C. (2022) Impact of cavity shaving on residual tumor rates in patients with primary invasive carcinoma and carcinoma in situ in breast conserving surgery. Archives of Gynecology and Obstetrics.

Veröffentlichungsdatum dieses Volltextes: 28 Nov 2022 08:33
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.53144


Zusammenfassung

Background Several international studies reported relatively high re-excision rates due to residual tumor in breast conserving surgery (BCS). Cavity shaving (CS) is a surgical strategy to reduce re-excision rates. This study aimed to investigate the effect of circumferential cavity shaving during BCS to reduce residual tumor. Material and Methods A total of 591 patients with early invasive ...

Background Several international studies reported relatively high re-excision rates due to residual tumor in breast conserving surgery (BCS). Cavity shaving (CS) is a surgical strategy to reduce re-excision rates. This study aimed to investigate the effect of circumferential cavity shaving during BCS to reduce residual tumor. Material and Methods A total of 591 patients with early invasive carcinoma or carcinoma in situ of the breast (ICD-10, C50 or D05) who were diagnosed between 01/01/2017 and 31/12/2019 and underwent BCS in a certified breast cancer center of the University Regensburg were analyzed regarding surgical excision methods. Patients with CS during BCS and patients with targeted re-excision in a specific direction depending on the result of intraoperative mammography or sonography during BCS were compared. The risk of pathologic residual tumor (R1) was compared between both groups by means of a multivariable binary logistic regression model to determine if there is a benefit of a certain surgical method to avoid a second intervention for re-excision. We adjusted for age, tumor size, nodal status, histologic type, surgeon, breast side, and neoadjuvant chemotherapy. Results 80 (n = 13.54%) patients had CS and 511 (n = 86.46%) had a targeted re-excision in a specific direction during BCS according to intraoperative mammography or sonography. After comparing both techniques in a multivariable regression model, there was no significant difference regarding risk of residual tumor (p = 0.738) in the total cohort. However, CS showed a tendency to be favorable regarding rates of residual tumor in patients with invasive breast cancer between 60 and 70 years (p = 0.072) and smaller T1-tumors (p = 0.057) compared to targeted intraoperative re-excision following mammographic or sonographic assessment. Conclusion CS showed a tendency to reduce residual tumor compared to the standard technique of intraoperative re-excision in specific subgroups, although no statistical significance was reached. Further studies are needed to overcome potential limitations like surgeon-based bias and missing standardized definitions of CS to reduce residual tumor rates.



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Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftArchives of Gynecology and Obstetrics
Verlag:SPRINGER HEIDELBERG
Ort der Veröffentlichung:HEIDELBERG
Datum25 Oktober 2022
InstitutionenMedizin > Lehrstuhl für Frauenheilkunde und Geburtshilfe (Schwerpunkt Frauenheilkunde)
Medizin > Zentren des Universitätsklinikums Regensburg > Tumorzentrum e.V.
Medizin > Institut für Epidemiologie und Präventivmedizin > Tumorzentrum e.V.
Identifikationsnummer
WertTyp
10.1007/s00404-022-06803-xDOI
Stichwörter / KeywordsONCOLOGY CONSENSUS GUIDELINE; AMERICAN SOCIETY; LOCAL RECURRENCE; MARGINS; CANCER; IRRADIATION; MANAGEMENT; TIME; ASSOCIATION; NEED; Breast conserving surgery; Cavity shaving; Invasive breast cancer; Re-excision rates; Residual tumor
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenJa
URN der UB Regensburgurn:nbn:de:bvb:355-epub-531446
Dokumenten-ID53144

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