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Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery.
Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery.
- Source :
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European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2019 Jun; Vol. 45 (6), pp. 976-982. Date of Electronic Publication: 2019 Feb 11. - Publication Year :
- 2019
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Abstract
- Background: This retrospective cohort study aims to compare surgical margins, reoperations and local recurrences after conventional or oncoplastic breast conservation surgery (BCS). Furthermore, we aim to investigate differences between various oncoplastic techniques.<br />Material and Methods: We reviewed 1800 consecutive patients with primary invasive breast cancer (N = 1707) or ductal carcinoma in situ (N = 93) who underwent BCS at Helsinki University Hospital between 2010 and 2012.<br />Results: Conventional BCS was performed in 1189 (66.1%) patients, oncoplastic BCS in 611 (33.9%). Various oncoplastic techniques were used. Patients with oncoplastic BCS had more often multifocal (p < 0.001), larger (p < 0.001), palpable tumours (p < 0.001) with larger resection specimens (p < 0.001). The amount of resected tissue varied substantially depending on the oncoplastic technique. Patients treated with oncoplastic BCS were younger (p < 0.001) and their tumours were more aggressive according to histological grade (p < 0.001), T-stage (p < 0.001), Ki-67 (p < 0.001) and lymph node status (p < 0.001). There was no difference, however, in surgical margins (p = 0.578) or reoperation rates (p = 0.430) between the groups. A total of 152 (8.4%) patients were reoperated because of insufficient margins, 96 (8.1%) in the conventional, 56 (9.2%) in the oncoplastic BCS group. The median follow-up time was 75 (2-94) months. There was no difference in local recurrence-free survival between the conventional and oncoplastic BCS groups (log-rank test, p = 0.172).<br />Conclusions: Oncoplastic BCS was used for larger, multifocal and more aggressive tumours. Nevertheless, no difference in reoperation rate or local recurrences were found. Oncoplastic BCS is as safe as conventional BCS enabling breast conserving for patients who otherwise were candidates for mastectomy.<br /> (Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
- Subjects :
- Biopsy
Breast Carcinoma In Situ diagnosis
Breast Neoplasms diagnosis
Disease-Free Survival
Female
Follow-Up Studies
Humans
Mammography
Reoperation
Retrospective Studies
Time Factors
Treatment Outcome
Breast Carcinoma In Situ surgery
Breast Neoplasms surgery
Margins of Excision
Mastectomy, Segmental methods
Neoplasm Recurrence, Local diagnosis
Neoplasm Staging methods
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2157
- Volume :
- 45
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 30795953
- Full Text :
- https://doi.org/10.1016/j.ejso.2019.02.010