Surgical De-Escalation for Re-Excision in Patients with a Margin Less Than 2 mm and a Diagnosis of DCIS

The current surgical guidelines recommend an optimal margin width of 2 mm for the management of patients diagnosed with ductal carcinoma in situ (DCIS). However, there are still many controversies regarding re-excision when the optimal margin criteria are not met in the first resection. The purpose...

Full description

Saved in:
Bibliographic Details
Published in:Cancers 2024-02, Vol.16 (4), p.743
Main Authors: Vanni, Gianluca, Pellicciaro, Marco, Di Lorenzo, Nicola, Barbarino, Rosaria, Materazzo, Marco, Tacconi, Federico, Squeri, Andrea, D'Angelillo, Rolando Maria, Berretta, Massimiliano, Buonomo, Oreste Claudio
Format: Article
Language:English
Subjects:
Basement membranes
Biopsy
Breast
Breast cancer
Breast surgery
Carcinoma
Carcinoma, Ductal
Care and treatment
Cell proliferation
Diagnosis
Diseases
Endocrine therapy
Health aspects
Lumpectomy
Lymphatic system
Mammography
Mastectomy
Medical research
Medicine, Experimental
Metastasis
Patients
Radiation
Radiation therapy
Regression analysis
Relapse
Surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The current surgical guidelines recommend an optimal margin width of 2 mm for the management of patients diagnosed with ductal carcinoma in situ (DCIS). However, there are still many controversies regarding re-excision when the optimal margin criteria are not met in the first resection. The purpose of this study is to understand the importance of surgical margin width, re-excision, and treatments to avoid additional surgery on locoregional recurrence (LRR). The study is retrospective and analyzed surgical margins, adjuvant treatments, re-excision, and LRR in patients with DCIS who underwent breast-conserving surgery (BCS). A total of 197 patients were enrolled. Re-operation for a close margin rate was 13.5%, and the 3-year recurrence was 7.6%. No difference in the LRR was reported among the patients subjected to BCS regardless of the margin width ( = 0.295). The recurrence rate according to margin status was not significant ( = 0.484). Approximately 36.9% (n: 79) patients had resection margins < 2 mm. A sub-analysis of patients with margins < 2 mm showed no difference in the recurrence between the patients treated with a second surgery and those treated with radiation ( = 0.091). The recurrence rate according to margin status in patients with margins < 2 mm was not significant ( = 0.161). The margin was not a predictive factor of LRR = 0.999. Surgical re-excision should be avoided in patients with a focally positive margin and no evidence of the disease at post-surgical imaging.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers16040743