title: Predictive factors for positive surgical margins in the treatment of breast ductal carcinoma in situ.
abstract: BACKGROUND
  Surgery is the main form of treatment for ductal carcinoma in situ (DCIS) of the breast. Among other factors, treatment success requires that the surgical margins are free of disease, to reduce the risk of recurrence.
  
  
  OBJECTIVE
  The purpose of this study was to analyze factors that might be associated with positive margins in patients diagnosed with DCIS.
  
  
  METHODS
  A retrospective analysis was performed of hospital databases from the year 2006 to 2014, to identify patients with an initial diagnosis of DCIS made by percutaneous biopsy.
  
  
  METHODS
  Age, the presence of disease symptoms, lesion size on mammogram, and the presence of estrogen receptors, and their relationship to the surgical margins were evaluated in 249 patients.
  
  
  METHODS
  Shapiro and Wilcoxon-Mann-Whitney tests were used to verify that the data were normally distributed. Chi-squared test was used to verify the independence of the variables.
  
  
  RESULTS
  Lesions measuring 1.55 cm or greater had a relative risk of positive margins after conservative surgery of 1.39 (95% confidence interval [95% CI]: 1.02-1.90). The presence of symptoms had a relative risk of positive margins after conservative surgery of 1.54 (95% CI: 1.17-2.02).
  
  
  CONCLUSIONS
  Lesions measuring 1.55 cm or greater and the presence of symptoms are risk factors for positive margins in the treatment of ductal carcinoma in situ. Therefore, these patients need a better surgical planning in order to reduce the risk of positive margins. There is a clear need for large prospective studies to validate our findings and define other factors that might contribute to the success of surgical resection for ductal carcinoma in situ.
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: Rafael A M
authors.initials: RA
authors.lastname: Hassan
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: Jonathan Y
authors.initials: JY
authors.lastname: Maesaka
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcos D
authors.initials: MD
authors.lastname: Ricci
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: José M
authors.initials: JM
authors.lastname: Soares
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: Maíra Teixeira
authors.initials: MT
authors.lastname: Dória
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: Edmund C
authors.initials: EC
authors.lastname: Baracat
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, São Paulo, Brazil.
authors.forename: José R
authors.initials: JR
authors.lastname: Filassi
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D000071960:Breast Carcinoma In Situ / Q000175:diagnosis* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D000072662:Margins of Excision; D008408:Mastectomy / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor