Does Surgical Margin Width Remain a Challenge for Triple-Negative Breast Cancer? A Retrospective Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Definitions (TNBC, Positive Surgical Resection Margin)
2.3. Clinicopathologic and Treatment Variables
2.4. Study Outcomes
2.5. Statistical Analysis
3. Results
3.1. Clinical, Pathological, and Treatment Characteristics
3.2. Local and Distant Recurrence, Kaplan–Meier Recurrence and Survival Outcomes, and Multivariate Analysis
3.3. NACT Subgroup Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Surgical Resection Margin Status | p Value | |
---|---|---|---|
≤2 mmn 1 (%) | >2 mmn (%) | ||
Age at surgery (years): | 0.46 | ||
Mean ± SD 2 | 47.02 ± 7.93 | 50.15 ± 11.13 | |
<50 | 3 (42.86) | 43 (50.59) | |
≥3 | 4 (57.14) | 42 (49.41) | |
Menopause: | 0.70 | ||
No | 4 (57.14) | 39 (45.88) | |
Yes | 3 (42.86) | 46 (54.12) | |
Clinical tumor size (cT): | 0.66 | ||
T1 (≤2 cm) | 1 (14.29) | 24 (28.24) | |
T2 + T3 (>2 cm) | 6 (85.71) | 61 (71.76) | |
Clinical lymph-node status (cN): | 0.44 | ||
Negative | 5 (71.43) | 44 (51.76) | |
Positive | 2 (28.57) | 41 (48.24) | |
Pathological tumor size (pT): | 0.44 | ||
T1 (≤2 cm) | 3 (42.86) | 51 (60.00) | |
T2 + T3 (>2 cm) | 4 (57.14) | 34 (40.00) | |
Pathological lymph-node status (pN): | 1.00 | ||
Negative | 5 (71.43) | 59 (69.41) | |
Positive | 2 (28.57) | 26 (30.59) | |
Lymphovascular invasion: | 0.41 | ||
Absent | 4 (57.14) | 61 (71.76) | |
Present | 3 (42.86) | 24 (28.24) | |
Nottingham score: | 0.44 | ||
I + II | 2 (28.57) | 40 (47.06) | |
III | 5 (71.43) | 45 (52.94) | |
Chemotherapy: | 0.410.67 | ||
Neoadjuvant | 1 (14.29) | 32 (37.65) | |
Adjuvant | 6 (85.71) | 58 (68.24) |
Surgical Resection Margin Status | Recurrence | p Value for LR 2 DR 3 | |
---|---|---|---|
Local n 1 (%) | Distant n (%) | ||
≤2 mm | 0 (0.00) | 0 (0.00) | 1.00 |
>2 mm | 5 (5.88) | 8 (9.41) | 1.00 |
≤3 mm | 1 (9.09) | 1 (9.09) | 0.47 |
>3 mm | 4 (4.93) | 7 (8.64) | 1.00 |
≤4 mm | 1 (7.14) | 2 (14.28) | 0.57 |
>4 mm | 4 (5.12) | 6 (7.69) | 0.35 |
≤5 mm | 1 (3.57) | 4 (14.28) | 1.00 |
>5 mm | 4 (6.25) | 4 (6.25) | 0.24 |
≤10 mm | 2 (3.92) | 5 (9.80) | 0.65 |
>10 mm | 3 (7.31) | 3 (7.31) | 0.72 |
Author/Study | Study Type | Number of Included Breast Cancer Patients | Results |
---|---|---|---|
Lowery A.J. et al. [21] | Meta-analysis | 12,592 7174 BCS 5418 mastectomy | Increased risk of LR 3 for TNBC patients |
Houssami N. et al. [29] | Meta-analysis | 14,571 14,571 BCS | Similar LR rates for different surgical margin widths (SMW) (1 versus 2 versus 5 mm; p > 0.10) |
Pilewskie M. et al. [30] | Observational retrospective study | 535 only TNBC 535 BCS | No difference in terms of LR (p = 0.11) and DR 4 (p = 0.53) for SMW ≤2 versus>2 mm |
AdkinsF.C. et al. [38] | Observational retrospective study | 1325 only TNBC 651 BCS 674 mastectomy | On multivariate analysis, close/positive margins were correlated with a higher LR risk |
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Bonci, E.-A.; Țîțu, Ș.; Petrușan, A.M.; Hossu, C.; Gâta, V.A.; Ghomi, M.T.; Kubelac, P.M.; Bonci, T.I.; Piciu, A.; Cosnarovici, M.; et al. Does Surgical Margin Width Remain a Challenge for Triple-Negative Breast Cancer? A Retrospective Analysis. Medicina 2021, 57, 203. https://doi.org/10.3390/medicina57030203
Bonci E-A, Țîțu Ș, Petrușan AM, Hossu C, Gâta VA, Ghomi MT, Kubelac PM, Bonci TI, Piciu A, Cosnarovici M, et al. Does Surgical Margin Width Remain a Challenge for Triple-Negative Breast Cancer? A Retrospective Analysis. Medicina. 2021; 57(3):203. https://doi.org/10.3390/medicina57030203
Chicago/Turabian StyleBonci, Eduard-Alexandru, Ștefan Țîțu, Alexandru Marius Petrușan, Claudiu Hossu, Vlad Alexandru Gâta, Morvarid Talaeian Ghomi, Paul Milan Kubelac, Teodora Irina Bonci, Andra Piciu, Maria Cosnarovici, and et al. 2021. "Does Surgical Margin Width Remain a Challenge for Triple-Negative Breast Cancer? A Retrospective Analysis" Medicina 57, no. 3: 203. https://doi.org/10.3390/medicina57030203