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Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery.
Eur J Surg Oncol 2019; 45(6):976-982EJ

Abstract

BACKGROUND

This retrospective cohort study aims to compare surgical margins, reoperations and local recurrences after conventional or oncoplastic breast conservation surgery (BCS). Furthermore, we aim to investigate differences between various oncoplastic techniques.

MATERIAL AND METHODS

We reviewed 1800 consecutive patients with primary invasive breast cancer (N = 1707) or ductal carcinoma in situ (N = 93) who underwent BCS at Helsinki University Hospital between 2010 and 2012.

RESULTS

Conventional BCS was performed in 1189 (66.1%) patients, oncoplastic BCS in 611 (33.9%). Various oncoplastic techniques were used. Patients with oncoplastic BCS had more often multifocal (p < 0.001), larger (p < 0.001), palpable tumours (p < 0.001) with larger resection specimens (p < 0.001). The amount of resected tissue varied substantially depending on the oncoplastic technique. Patients treated with oncoplastic BCS were younger (p < 0.001) and their tumours were more aggressive according to histological grade (p < 0.001), T-stage (p < 0.001), Ki-67 (p < 0.001) and lymph node status (p < 0.001). There was no difference, however, in surgical margins (p = 0.578) or reoperation rates (p = 0.430) between the groups. A total of 152 (8.4%) patients were reoperated because of insufficient margins, 96 (8.1%) in the conventional, 56 (9.2%) in the oncoplastic BCS group. The median follow-up time was 75 (2-94) months. There was no difference in local recurrence-free survival between the conventional and oncoplastic BCS groups (log-rank test, p = 0.172).

CONCLUSIONS

Oncoplastic BCS was used for larger, multifocal and more aggressive tumours. Nevertheless, no difference in reoperation rate or local recurrences were found. Oncoplastic BCS is as safe as conventional BCS enabling breast conserving for patients who otherwise were candidates for mastectomy.

Authors+Show Affiliations

Breast Surgery Unit, Comprehensive Cancer Center, University of Helsinki, Helsinki University Hospital Finland, P.O. Box 263, 00029, HUS, Finland. Electronic address: laura.niinikoski@hus.fi.Breast Surgery Unit, Comprehensive Cancer Center, University of Helsinki, Helsinki University Hospital Finland, P.O. Box 263, 00029, HUS, Finland.Breast Surgery Unit, Comprehensive Cancer Center, University of Helsinki, Helsinki University Hospital Finland, P.O. Box 263, 00029, HUS, Finland.Breast Surgery Unit, Comprehensive Cancer Center, University of Helsinki, Helsinki University Hospital Finland, P.O. Box 263, 00029, HUS, Finland.Department of Pathology, University of Helsinki, Helsinki University Hospital Finland, P.O. Box 400, 00029, HUS, Finland.Comprehensive Cancer Center, University of Helsinki, Helsinki University Hospital Finland, PO Box 180, 00029, HUS, Finland.Breast Surgery Unit, Comprehensive Cancer Center, University of Helsinki, Helsinki University Hospital Finland, P.O. Box 263, 00029, HUS, Finland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30795953

Citation

Niinikoski, Laura, et al. "Resection Margins and Local Recurrences in Breast Cancer: Comparison Between Conventional and Oncoplastic Breast Conserving Surgery." European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 45, no. 6, 2019, pp. 976-982.
Niinikoski L, Leidenius MHK, Vaara P, et al. Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery. Eur J Surg Oncol. 2019;45(6):976-982.
Niinikoski, L., Leidenius, M. H. K., Vaara, P., Voynov, A., Heikkilä, P., Mattson, J., & Meretoja, T. J. (2019). Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery. European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 45(6), pp. 976-982. doi:10.1016/j.ejso.2019.02.010.
Niinikoski L, et al. Resection Margins and Local Recurrences in Breast Cancer: Comparison Between Conventional and Oncoplastic Breast Conserving Surgery. Eur J Surg Oncol. 2019;45(6):976-982. PubMed PMID: 30795953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery. AU - Niinikoski,Laura, AU - Leidenius,Marjut H K, AU - Vaara,Päivi, AU - Voynov,Aleksandar, AU - Heikkilä,Päivi, AU - Mattson,Johanna, AU - Meretoja,Tuomo J, Y1 - 2019/02/11/ PY - 2018/11/02/received PY - 2019/01/11/revised PY - 2019/02/06/accepted PY - 2019/2/24/pubmed PY - 2019/2/24/medline PY - 2019/2/24/entrez KW - Breast cancer KW - Breast conserving surgery KW - Local recurrence KW - Reoperations KW - Surgical margins SP - 976 EP - 982 JF - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology JO - Eur J Surg Oncol VL - 45 IS - 6 N2 - BACKGROUND: This retrospective cohort study aims to compare surgical margins, reoperations and local recurrences after conventional or oncoplastic breast conservation surgery (BCS). Furthermore, we aim to investigate differences between various oncoplastic techniques. MATERIAL AND METHODS: We reviewed 1800 consecutive patients with primary invasive breast cancer (N = 1707) or ductal carcinoma in situ (N = 93) who underwent BCS at Helsinki University Hospital between 2010 and 2012. RESULTS: Conventional BCS was performed in 1189 (66.1%) patients, oncoplastic BCS in 611 (33.9%). Various oncoplastic techniques were used. Patients with oncoplastic BCS had more often multifocal (p < 0.001), larger (p < 0.001), palpable tumours (p < 0.001) with larger resection specimens (p < 0.001). The amount of resected tissue varied substantially depending on the oncoplastic technique. Patients treated with oncoplastic BCS were younger (p < 0.001) and their tumours were more aggressive according to histological grade (p < 0.001), T-stage (p < 0.001), Ki-67 (p < 0.001) and lymph node status (p < 0.001). There was no difference, however, in surgical margins (p = 0.578) or reoperation rates (p = 0.430) between the groups. A total of 152 (8.4%) patients were reoperated because of insufficient margins, 96 (8.1%) in the conventional, 56 (9.2%) in the oncoplastic BCS group. The median follow-up time was 75 (2-94) months. There was no difference in local recurrence-free survival between the conventional and oncoplastic BCS groups (log-rank test, p = 0.172). CONCLUSIONS: Oncoplastic BCS was used for larger, multifocal and more aggressive tumours. Nevertheless, no difference in reoperation rate or local recurrences were found. Oncoplastic BCS is as safe as conventional BCS enabling breast conserving for patients who otherwise were candidates for mastectomy. SN - 1532-2157 UR - https://www.unboundmedicine.com/medline/citation/30795953/Resection_margins_and_local_recurrences_in_breast_cancer:_Comparison_between_conventional_and_oncoplastic_breast_conserving_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0748-7983(19)30279-3 DB - PRIME DP - Unbound Medicine ER -