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.
N1 - Funding Information:
ACKNOWLEDGMENT The University of Texas MD Anderson Cancer Center is supported in part by the National Institutes of Health through Cancer Center Support Grant CA016672. The authors thank Stephanie Deming for editorial assistance.
PY - 2013
Y1 - 2013
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
SN - 1068-9265
VL - 20
SP - 4103
EP - 4112
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 13
ER -