title: What should be the width of radiological margin to optimize resection of non-palpable invasive or in situ ductal carcinoma?
abstract: OBJECTIVE
  the aim of our study was to investigate whether there is radiological margin that optimize resection of non-palpable invasive or in situ ductal carcinoma.
  
  
  METHODS
  Data were collected for all patients undergoing wire localization prior to therapeutic surgical excision between January 2010 and December 2013 at our institution. A 5 and 10-mm radiological margins were considered adequate for invasive ductal carcinoma (IDC) and in situ ductal carcinoma (DCIS) respectively. Clear histological margins were defined as no ink on the tumor for IDC and ≥2 mm for DCIS. Data were analyzed both in order to assess accuracy of the technique and in order to determine what radiological threshold should be taken.
  
  
  RESULTS
  Three hundred seventy seven women were included to the study. The radiological thresholds permitted negative histological margins in 94.7%, 60.9% and 80.9% in the pure invasive ductal carcinoma group (IDC, n = 133), the pure ductal carcinoma in situ group (DCIS, n = 92) and the mixed group (both IDC and DCIS, n = 152) respectively. In an ROC analysis evaluating the ability of radiological thresholds to obtain free pathological margins: the AUC was 0.79 (0.71-0.87, 95% confident interval, p = .0007) for Pure IDC group, 0.67 (0.57-0.87, 95% confident interval, p = .0005) for pure DCIS group, and 0.72 (0.62-0.80, 95% confident interval, p < .0001) for the mixed group.
  
  
  CONCLUSIONS
  We found that a radiological margin of 10 mm is needed in presence of an in situ component and 5-mm radiological margin seems enough in case of pure IDC tumors.
authors.affiliation: Department of Gynecology, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France; INSERM Unit 1069, Tours, France; François-Rabelais University, Tours, France. Electronic address: l.ouldamer@chu-tours.fr.
authors.forename: Lobna
authors.initials: L
authors.lastname: Ouldamer
authors.affiliation: Department of Gynecology, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France; François-Rabelais University, Tours, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Lechaux
authors.affiliation: Department of Pathology, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France.
authors.forename: Flavie
authors.initials: F
authors.lastname: Arbion
authors.affiliation: Department of Gynecology, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France; François-Rabelais University, Tours, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Body
authors.affiliation: Department of Radiology, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Vildé
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D018365:Neoplasm, Residual; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016217:Ultrasonography, Mammary
keywords: Breast cancer; Non palpable; Radiological margin