Macroscopic Intraoperative Margin Assessment and Risk Factors of Margin Involvement in Breast Cancer Conserving Surgery

Andrea Goikoetxea Urdiain1*, Pedro Armendáriz Rubio1, Natalia Moras Pérez1, Arkaitz Galbete Jiménez2, Yerani Ruiz de Azúa Ciria3 and Cristina Artieda Soto1

1Department of General Surgery, Complejo Hospitalario de Navarra, Spain
2Department of Statistics, Complejo Hospitalario de Navarra, Spain
3Department of Pathology, Complejo Hospitalario de Navarra, Spain

^*Correspondance to: Andrea Goikoetxea Urdiain 

 PDF  Full Text DOI: 10.25107/2474-1647.3235

Abstract

Background: Surgical margin status after Breast-Conserving Surgery (BCS) is an important prognostic factor in breast cancer treatment. Objective: To assess whether the protocol applied for intraoperative evaluation of the surgical specimen could affect the rate of margin involvement and to analyze other risk factors influencing margin status. Methods: We identified patients treated with BCS between 2004 and 2015 at a breast cancer referral center. Invasive lesions underwent an intraoperative macroscopic pathologic evaluation, using “ink on tumor” as margin definition. Multivariate logistic regression methods identified the risk factors for surgical margin involvement. Results: Of 1,054 patients receiving BCS, intraoperative margin assessment was performed in 78.3%. Failure to accomplish an intraoperative evaluation of margins was strongly associated with the rate of positive margins: 27.5% compared to 6.1% in the group whose margins were assessed. The overall definitive rate of inadequate margins was 10.7%. The multivariate study identified the following variables as independent predictors of margin involvement: Absence of intraoperative pathologic assessment of the margin, younger age, personal history of benign breast pathology, lack of preoperative diagnosis, intraductal histology and tumor size. Conclusion: These clinicopathologic factors should be considered when planning BCS. Our systematic approach is an important strategy to reduce surgical reoperations.

Keywords

Intraoperative macroscopic margin assessment; Margin involvement risk factors; Breast-conserving surgery; Breast cancer

Cite the article

Urdiain AG, Rubio PA, Pérez NM, Jiménez AG, de Azúa Ciria YR, Soto CA. Macroscopic Intraoperative Margin Assessment and Risk Factors of Margin Involvement in Breast Cancer Conserving Surgery. Clin Surg. 2021; 6: 3235..