Incidence and consequence of close margins in patients with ductal carcinoma-in situ treated with mastectomy: Is further therapy warranted?

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Abstract

Background. The impact of close margins in patients with ductal carcinoma-in situ (DCIS) treated with mastectomy is unclear; however, this finding may lead to a recommendation for postmastectomy radiotherapy (PMRT). We sought to determine the incidence and consequences of close margins in patients with DCIS treated with mastectomy. Methods. The records of 810 patients with DCIS treated with mastectomy from 1996 through 2009 were reviewed. Clinical and pathologic factors were analyzed with respect to final margin status. Median follow-up was 6.3 years. Results. Overall, 94 patients (11.7 %) had close margins (positive, n = 5; negative but B1 mm, n = 54; 1.1-2.9 mm, n = 35). Independent risk factors for close margins included multicentricity, pathologic lesion size C1.5 cm, and necrosis, but not age, use of skin-sparing mastectomy, or immediate reconstruction (p[0.05). Seven patients received PMRT, and none had a locoregional recurrence (LRR). Among the remaining 803 patients, the 10-year LRR rate was 1 %(5.0 % for margins B1 mm, 3.6 %for margins 1.1-2.9 mm, and 0.7 % for margins C3 mm [p\0.001]).

Original languageEnglish (US)
Pages (from-to)4103-4112
Number of pages10
JournalAnnals of surgical oncology
Volume20
Issue number13
DOIs
StatePublished - Aug 26 2013

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Carcinoma, Intraductal, Noninfiltrating
Mastectomy
Incidence
Radiotherapy
Therapeutics
Recurrence
Necrosis
Skin

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

@article{87ea8891606345dfb7c8b5e3e8849269,
title = "Incidence and consequence of close margins in patients with ductal carcinoma-in situ treated with mastectomy: Is further therapy warranted?",
abstract = "Background. The impact of close margins in patients with ductal carcinoma-in situ (DCIS) treated with mastectomy is unclear; however, this finding may lead to a recommendation for postmastectomy radiotherapy (PMRT). We sought to determine the incidence and consequences of close margins in patients with DCIS treated with mastectomy. Methods. The records of 810 patients with DCIS treated with mastectomy from 1996 through 2009 were reviewed. Clinical and pathologic factors were analyzed with respect to final margin status. Median follow-up was 6.3 years. Results. Overall, 94 patients (11.7 {\%}) had close margins (positive, n = 5; negative but B1 mm, n = 54; 1.1-2.9 mm, n = 35). Independent risk factors for close margins included multicentricity, pathologic lesion size C1.5 cm, and necrosis, but not age, use of skin-sparing mastectomy, or immediate reconstruction (p[0.05). Seven patients received PMRT, and none had a locoregional recurrence (LRR). Among the remaining 803 patients, the 10-year LRR rate was 1 {\%}(5.0 {\%} for margins B1 mm, 3.6 {\%}for margins 1.1-2.9 mm, and 0.7 {\%} for margins C3 mm [p\0.001]).",
author = "Elizabeth FitzSullivan and Lari, {Sara A.} and Benjamin Smith and Caudle, {Abigail S.} and Savitri Krishnamurthy and Anthony Lucci and Mittendorf, {Elizabeth A.} and Babiera, {Gildy V.} and Black, {Dalliah M.} and Wagner, {Jamie L.} and Isabelle Bedrosian and Wendy Woodward and Gainer, {Sarah M.} and Rosa Hwang and Funda Meric-Bernstam and Hunt, {Kelly K.} and Kuerer, {Henry M.}",
year = "2013",
month = "8",
day = "26",
doi = "10.1245/s10434-013-3194-0",
language = "English (US)",
volume = "20",
pages = "4103--4112",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "13",

}

TY - JOUR

T1 - Incidence and consequence of close margins in patients with ductal carcinoma-in situ treated with mastectomy

T2 - Is further therapy warranted?

AU - FitzSullivan, Elizabeth

AU - Lari, Sara A.

AU - Smith, Benjamin

AU - Caudle, Abigail S.

AU - Krishnamurthy, Savitri

AU - Lucci, Anthony

AU - Mittendorf, Elizabeth A.

AU - Babiera, Gildy V.

AU - Black, Dalliah M.

AU - Wagner, Jamie L.

AU - Bedrosian, Isabelle

AU - Woodward, Wendy

AU - Gainer, Sarah M.

AU - Hwang, Rosa

AU - Meric-Bernstam, Funda

AU - Hunt, Kelly K.

AU - Kuerer, Henry M.

PY - 2013/8/26

Y1 - 2013/8/26

N2 - Background. The impact of close margins in patients with ductal carcinoma-in situ (DCIS) treated with mastectomy is unclear; however, this finding may lead to a recommendation for postmastectomy radiotherapy (PMRT). We sought to determine the incidence and consequences of close margins in patients with DCIS treated with mastectomy. Methods. The records of 810 patients with DCIS treated with mastectomy from 1996 through 2009 were reviewed. Clinical and pathologic factors were analyzed with respect to final margin status. Median follow-up was 6.3 years. Results. Overall, 94 patients (11.7 %) had close margins (positive, n = 5; negative but B1 mm, n = 54; 1.1-2.9 mm, n = 35). Independent risk factors for close margins included multicentricity, pathologic lesion size C1.5 cm, and necrosis, but not age, use of skin-sparing mastectomy, or immediate reconstruction (p[0.05). Seven patients received PMRT, and none had a locoregional recurrence (LRR). Among the remaining 803 patients, the 10-year LRR rate was 1 %(5.0 % for margins B1 mm, 3.6 %for margins 1.1-2.9 mm, and 0.7 % for margins C3 mm [p\0.001]).

AB - Background. The impact of close margins in patients with ductal carcinoma-in situ (DCIS) treated with mastectomy is unclear; however, this finding may lead to a recommendation for postmastectomy radiotherapy (PMRT). We sought to determine the incidence and consequences of close margins in patients with DCIS treated with mastectomy. Methods. The records of 810 patients with DCIS treated with mastectomy from 1996 through 2009 were reviewed. Clinical and pathologic factors were analyzed with respect to final margin status. Median follow-up was 6.3 years. Results. Overall, 94 patients (11.7 %) had close margins (positive, n = 5; negative but B1 mm, n = 54; 1.1-2.9 mm, n = 35). Independent risk factors for close margins included multicentricity, pathologic lesion size C1.5 cm, and necrosis, but not age, use of skin-sparing mastectomy, or immediate reconstruction (p[0.05). Seven patients received PMRT, and none had a locoregional recurrence (LRR). Among the remaining 803 patients, the 10-year LRR rate was 1 %(5.0 % for margins B1 mm, 3.6 %for margins 1.1-2.9 mm, and 0.7 % for margins C3 mm [p\0.001]).

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U2 - 10.1245/s10434-013-3194-0

DO - 10.1245/s10434-013-3194-0

M3 - Article

C2 - 23975313

AN - SCOPUS:84892372678

VL - 20

SP - 4103

EP - 4112

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 13

ER -