J Korean Surg Soc. 2013 Mar;84(3):154-9. doi: 10.4174/jkss.2013.84.3.154. Epub 2013 Feb 27.

Factors affecting surgical margin positivity in invasive ductal breast cancer patients who underwent breast-conserving surgery after preoperative core biopsy diagnosis.

Journal of the Korean Surgical Society

Bulent Koca, Bekir Kuru, Savas Yuruker, Barıs Gokgul, Necati Ozen

PMID: 23487000 PMCID: PMC3594642 DOI: 10.4174/jkss.2013.84.3.154

Abstract

PURPOSE: The aim of our study is to evaluate the factors affecting surgical margin positivity among patients with invasive ductal breast cancer who underwent breast-conserving surgery (BCS) after preoperative diagnostic core biopsy.

METHODS: Two hundred sixteen patients with stage I, II invasive ductal breast carcinoma who had histological diagnosis with preoperative tru-cut biopsy and underwent BCS were included in the present study. Potential factors that affect the positive surgical margin were analyzed. In univariate analysis, the comparisons of the factors affecting the surgical margin positivity were made by chi-square test. Logistic regression test was used to detect the independent factors affecting the surgical margin positivity.

RESULTS: Positive axillary lymph node (odds ratio [OR], 8.2; 95% confidence interval [CI], 3.01 to 22.12), lymphovascular invasion (LVI; OR, 3.9; 95% CI, 1.62 to 9.24), extensive intraductal component (EIC; OR, 6.1; 95% CI, 2.30 to 16.00), presence of spiculation (OR, 5.1; 95% CI, 2.00 to 13.10) or presence of microcalcification in the mammography (OR, 13.7; 95% CI, 4.04 to 46.71) have been found to be the independent and adverse factors affecting surgical margin positivity.

CONCLUSION: Considering decision making for the extent of the excision and for achieving negative surgical margin before BCS, positive axillary lymph node, LVI, EIC, spiculation or microcalcification in mammography are related as predictor factors for positive surgical margin.

Keywords: Breast ductal carcinoma; Large-core needle biopsy; Segmental mastectomy

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