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Annals of Surgical Oncology

, Volume 24, Issue 6, pp 1516–1524 | Cite as

Cavity Shaving Reduces Involved Margins and Reinterventions Without Increasing Costs in Breast-Conserving Surgery: A Propensity Score-Matched Study

  • Fabio CorsiEmail author
  • Luca Sorrentino
  • Matteo Bonzini
  • Daniela Bossi
  • Marta Truffi
  • Rosella Amadori
  • Manuela Nebuloni
  • Barbara Brillat
  • Serena Mazzucchelli
Breast Oncology

Abstract

Background

Currently, reinterventions for involved margins after breast-conserving surgery remain common. The aim of this study was to assess the capability of the cavity shave margins (CSM) technique to reduce positive margin rates and reoperations compared with simple lumpectomy (SL). The impact of CSM on the various biological portraits of breast cancer and costs were also investigated.

Methods

A retrospective review of 976 consecutive patients from a single center was performed; 164 patients underwent SL and 812 received CSM. All patients were treated with an oncoplastic approach. and involved margins and reoperations were compared for each group. To avoid selection bias, propensity score-matched analysis was performed before applying a logistic regression model. Main outcomes were reanalyzed for each biological portrait, and surgery and hospitalization costs for SL and CSM were compared.

Results

Clear margins were found in 98.3% of patients in the CSM group versus 74.4% of patients in the SL group (p < 0.001). The reoperation rate was 18.9% in the SL group and 1.9% in the CSM group (p < 0.001). After propensity score-matched logistic regression, odds ratio (OR) for positive final margin status was 6.2 (95% confidence interval [CI] 2.85–13.46; p < 0.001) without CSM, while OR for reintervention was 5.46 (95% CI 2.21–13.46; p < 0.001). CSM significantly reduced positive margins and reexcisions for Luminal A, Luminal B, and triple-negative breast cancers (p < 0.001, p < 0.001, and p = 0.0137, respectively). SL had higher global costs compared with CSM: €193,630.6 versus €177,830 for 100 treated patients (p = 0.009).

Conclusions

CSM reduces reexcisions, mainly in luminal breast cancers, without increasing costs.

Keywords

Propensity Score Positive Margin Propensity Score Analysis Positive Margin Rate Reintervention Rate 
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.

Notes

Funding

No funding was provided for this study

Disclosure

Fabio Corsi, Luca Sorrentino, Matteo Bonzini, Daniela Bossi, Marta Truffi, Rosella Amadori, Manuela Nebuloni, Barbara Brillat, Serena Mazzucchelli report no competing interests and no conflicts of interest.

Supplementary material

10434_2017_5774_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 13 kb)

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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Fabio Corsi
    • 1
    • 2
    Email author
  • Luca Sorrentino
    • 3
  • Matteo Bonzini
    • 4
  • Daniela Bossi
    • 1
  • Marta Truffi
    • 2
  • Rosella Amadori
    • 5
  • Manuela Nebuloni
    • 6
  • Barbara Brillat
    • 3
  • Serena Mazzucchelli
    • 2
  1. 1.Surgery Department, Breast UnitIRCCS Maugeri Foundation HospitalPaviaItaly
  2. 2.Department of Biomedical and Clinical SciencesUniversity of Milan, “Luigi Sacco” HospitalMilanItaly
  3. 3.Surgery Division, Department of Clinical SciencesUniversity of Milan, “Luigi Sacco” HospitalMilanItaly
  4. 4.Department of Clinical Sciences and Community HealthUniversity of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  5. 5.Division of Radiology“Luigi Sacco” HospitalMilanItaly
  6. 6.Department of Pathology, Department of Clinical SciencesUniversity of Milan, “Luigi Sacco” HospitalMilanItaly

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