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Indication for relumpectomy—a useful scoring system in cases of invasive breast cancer
Author(s) -
Halevy Ariel,
Lavy Ron,
Pappo Itzhak,
Davidson Tima,
GoldDeutch Ruth,
Jeroukhimov Igor,
Shapira Zahar,
Wassermann Ilan,
Sandbank Judith,
Chikman Bar
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22027
Subject(s) - medicine , lumpectomy , breast cancer , logistic regression , univariate analysis , lymphovascular invasion , univariate , invasive lobular carcinoma , multivariate analysis , stepwise regression , cancer , radiology , mastectomy , multivariate statistics , invasive ductal carcinoma , metastasis , statistics , mathematics
Background and Objectives In two‐thirds of breast cancer patients undergoing reoperation no residual tumor will be found. A scoring system for selection of patients who might benefit from relumpectomy is proposed. Methods This study is based on 293 patients with invasive breast cancer undergoing reoperation due to margins of <2 mm. Eighteen parameters were evaluated by univariate and multivariate stepwise logistic regression. Results Univariate analysis identified nine parameters associated with a residual invasive tumor: surgical margins; lobular histological type; grade 3; multifocality; positive lymph modes; non‐fine needle localization (FNL) versus FNL lumpectomy; vascular/lymphatic invasion; age <50 years; and tumor size ≥3 cm. Multivariate stepwise logistic regression study identified six out of nine parameters associated with a higher probability of finding a residual invasive tumor: margins <1 mm, multifocality, tumor size ≥3 cm, positive lymph nodes, age <50 years, and lumpectomy without previous FNL. Odds of these factors were used for scoring. Conclusions For patients with surgical margins <2 mm and a score of <4, the probability of finding a residual invasive tumor is 0%, while the probability of finding a microfocus of <2 mm of invasive carcinoma is 3.2% and of finding residual DCIS is up to 10%. J. Surg. Oncol. 2012;105:376–380. © 2011 Wiley Periodicals, Inc.