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Annals of Surgical Oncology

, Volume 22, Supplement 3, pp 422–427 | Cite as

Impact of Consensus Guidelines by the Society of Surgical Oncology and the American Society for Radiation Oncology on Margins for Breast-Conserving Surgery in Stages 1 and 2 Invasive Breast Cancer

  • A. ChungEmail author
  • A. Gangi
  • F. Amersi
  • S. Bose
  • X. Zhang
  • A. Giuliano
Breast Oncology

Abstract

Background

This study aimed to evaluate the impact that the release of consensus guidelines for margins in breast-conserving surgery (BCS) had on re-excision rates.

Methods

A retrospective review examined a prospectively maintained database of patients who had operable invasive breast cancer treated with BCS at the authors’ institution. The patients were divided into two groups: (1) those with a diagnosis determined from 1 July 2011 to 31 July 2013 (before release of the guidelines) and (2) those with a diagnosis determined from 1 February 2014 to 31 July 2014 (after release of the guidelines). The groups were evaluated with respect to patient and tumor characteristics, re-excision rates, and reasons for re-excision.

Results

A total of 846 cases of BCS were managed: 597 in group 1 and 249 in group 2. Re-excision rates were significantly reduced after release of the consensus guidelines (p = 0.03). Re-excisions were performed for 115 (19 %) of 597 patients in group 1 and 32 (13 %) of 249 patients in group 2. After release of the guidelines, re-excisions were performed for positive margins, as defined by the consensus statement, in 25 (78 %) of 32 cases. The two groups did not differ significantly in terms of age, tumor size, grade, nodal status, estrogen receptor status, progesterone receptor status, or human epidermal growth factor receptor 2 status. Group 1 had more tumors of mixed ductal and lobular histology than group 2, and group 2 had more lobular tumors than group 1 (p = 0.02).

Conclusions

The consensus guidelines on margins for BCS were applied for 78 % of the patients who underwent re-excision and resulted in a significant reduction in re-excision rates.

Keywords

Consensus Statement Negative Margin Estrogen Receptor Status Margin Width Progesterone Receptor Status 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • A. Chung
    • 1
    Email author
  • A. Gangi
    • 1
  • F. Amersi
    • 1
  • S. Bose
    • 2
  • X. Zhang
    • 3
  • A. Giuliano
    • 1
  1. 1.Division of Surgical Oncology, Department of SurgeryCedars-Sinai Medical CenterLos AngelesUSA
  2. 2.Department of PathologyCedars-Sinai Medical CenterLos AngelesUSA
  3. 3.Department of BiostatisticsCedars-Sinai Medical CenterLos AngelesUSA

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