title: Low rate of positive margins and re-excision after partial mastectomy in highly selected breast cancer patients: A Chinese single-institution experience.
abstract: A recent randomized controlled trial firstly demonstrated that cavity shaving significantly decreased the rate of positive margins and re-excision among partial mastectomy (PM) patients. However, it remains unknown whether cavity shaving should be routinely applied to Chinese breast cancer patients undergoing PM. A total of 408 PM patients undergoing 410 PMs among 1796 surgically treated breast cancer patients at Fudan University Shanghai Cancer Centre from January 2015 to June 2015 were included in our study. Data were analysed with univariate or multivariate analysis. Overall, 11 of 410 cases (2.7%) had positive margins postoperatively. Moreover, only 24.6% of the cases (P<0.05) presented with ductal carcinoma in situ (DCIS), among whom 10.0% obtained positive margins. In multivariate logistic regression analysis, presence of mammographic calcifications was significantly associated with margin positivity (P<0.05, OR=6.06, 95% CI: 1.53-23.91). In conclusion, cavity shaving during PM should not be routinely performed in Chinese breast cancer patients, particularly in highly selected cases with a low prevalence of DCIS. PM patients with preoperative mammographic calcifications were more likely to have positive margins and might benefit more from cavity shaving.
authors.affiliation: Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Siyu
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of General Surgery, Jinshan Hospital, Fudan University, Shanghai, P.R. China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Zhaozhi
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Clinical Statistics Center, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Miao
authors.initials: M
authors.lastname: Mo
authors.affiliation: Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Gao
authors.affiliation: Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Guangyu
authors.initials: G
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001941:Breast Diseases / Q000473:pathology; D001943:Breast Neoplasms / Q000208:ethnology / Q000473:pathology / Q000601:surgery*; D002114:Calcinosis / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000208:ethnology / Q000473:pathology / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000208:ethnology / Q000473:pathology / Q000601:surgery*; D002681:China; D005260:Female; D006801:Humans; D016015:Logistic Models; D000072662:Margins of Excision; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D012086:Reoperation; D055815:Young Adult
keywords: Chinese; highly selected; low rate; partial mastectomy; positive margins