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Success rates of re-excision after positive margins for invasive lobular carcinoma of the breast.


ABSTRACT: Rates of positive margins after surgical resection of invasive lobular carcinoma (ILC) are high (ranging from 18 to 60%), yet the efficacy of re-excision lumpReceptor subtypeectomy for clearing positive margins is unknown. Concerns about the diffuse nature of ILC may drive increased rates of completion mastectomy to treat positive margins, thus lowering breast conservation rates. We therefore determined the success rate of re-excision lumpectomy in women with ILC and positive margins after surgical resection. We identified 314 cases of stage I-III ILC treated with breast conserving surgery (BCS) at the University of California, San Francisco. Surgical procedures, pathology reports, and outcomes were analyzed using univariate and multivariate statistics and Cox-proportional hazards models. We evaluated outcomes before and after the year 2014, when new margin management consensus guidelines were published. Positive initial margins occurred in 118 (37.6%) cases. Of these, 62 (52.5%) underwent re-excision lumpectomy, which cleared the margin in 74.2%. On multivariate analysis, node negativity was significantly associated with successful re-excision (odds ratio [OR] 3.99, 95% CI 1.15-13.81, p?=?0.029). After 2014, we saw fewer initial positive margins (42.7% versus 25.5%, p?=?0.009), second surgeries (54.6% versus 20.2%, p?

SUBMITTER: Piper ML 

PROVIDER: S-EPMC6731236 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Success rates of re-excision after positive margins for invasive lobular carcinoma of the breast.

Piper Merisa L ML   Wong Jasmine J   Fahrner-Scott Kelly K   Ewing Cheryl C   Alvarado Michael M   Esserman Laura J LJ   Mukhtar Rita A RA  

NPJ breast cancer 20190906


Rates of positive margins after surgical resection of invasive lobular carcinoma (ILC) are high (ranging from 18 to 60%), yet the efficacy of re-excision lumpReceptor subtypeectomy for clearing positive margins is unknown. Concerns about the diffuse nature of ILC may drive increased rates of completion mastectomy to treat positive margins, thus lowering breast conservation rates. We therefore determined the success rate of re-excision lumpectomy in women with ILC and positive margins after surgi  ...[more]

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