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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

  • Breast Oncology
  • Published:
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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.

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Author information

Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    A. Chung MD, A. Gangi MD, F. Amersi MD & A. Giuliano MD

  2. Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    S. Bose MD

  3. Department of Biostatistics, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    X. Zhang PhD

Authors
  1. A. Chung MD
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  2. A. Gangi MD
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  3. F. Amersi MD
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  4. S. Bose MD
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  5. X. Zhang PhD
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  6. A. Giuliano MD
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Correspondence to A. Chung MD.

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Chung, A., Gangi, A., Amersi, F. et al. 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. Ann Surg Oncol 22 (Suppl 3), 422–427 (2015). https://doi.org/10.1245/s10434-015-4829-0

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  • DOI: https://doi.org/10.1245/s10434-015-4829-0

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