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Does Breast Density Increase the Risk of Re-excision for Women with Breast Cancer Having Breast-Conservation Therapy?

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Women with dense breasts may have less-accurate preoperative evaluation of extent of disease, potentially affecting the achievement of negative margins. The goal of this study is to examine the association between breast density and re-excision rates in women having breast-conserving surgery for invasive breast cancer.

Patients and Methods

Women with stage I/II invasive breast cancer treated with breast-conserving surgery between 1/1/2014 and 10/31/2014 were included. Breast density was assessed by two radiologists. The association between breast density and re-excision was examined using logistic regression.

Results

Seven hundred and one women were included. Overall, 106 (15.1%) women had at least one re-excision. Younger age at diagnosis was associated with increased breast density (p < 0.001). On univariable analysis, increased breast density was associated with significantly increased odds of re-excision (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.04–1.83), as was multifocal disease, human epidermal growth factor receptor 2 (HER2) positive status, and extensive intraductal component (EIC) (all p < 0.05). On multivariable analysis, breast density remained significantly associated with increased odds of re-excision (OR 1.37, 95% CI 1.00–1.86), as did multifocality and EIC. HER2 positive status was not significantly associated with re-excision on multivariable analysis.

Conclusions

Women with dense breasts are more likely to need additional surgery (re-excision after breast-conserving surgery), but increased breast density did not adversely affect disease-free survival in our study. Our findings support the need for further study in developing techniques that can help decrease re-excisions for women with dense breasts who undergo breast-conserving surgery.

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Acknowledgment

The preparation of this manuscript was funded in part by NIH/NCI Cancer Center Support Grant No. P30 CA008748 to Memorial Sloan Kettering Cancer Center, and this study was presented in poster format at the 40th Annual San Antonio Breast Cancer Symposium, December 5–9, 2017, San Antonio, TX.

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Authors and Affiliations

  1. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Siun M. Walsh MD, Laura H. Rosenberger MD, Michelle Stempel MPH & Mary L. Gemignani MD, MPH

  2. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Sandra B. Brennan MD & Lizza Lebron-Zapata MD

  3. Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Emily C. Zabor DrPH

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  1. Siun M. Walsh MD
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  2. Sandra B. Brennan MD
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  3. Emily C. Zabor DrPH
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  4. Laura H. Rosenberger MD
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  5. Michelle Stempel MPH
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  6. Lizza Lebron-Zapata MD
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  7. Mary L. Gemignani MD, MPH
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Correspondence to Mary L. Gemignani MD, MPH.

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Walsh, S.M., Brennan, S.B., Zabor, E.C. et al. Does Breast Density Increase the Risk of Re-excision for Women with Breast Cancer Having Breast-Conservation Therapy?. Ann Surg Oncol 26, 4246–4253 (2019). https://doi.org/10.1245/s10434-019-07647-7

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  • DOI: https://doi.org/10.1245/s10434-019-07647-7

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