Myriam Mimouni1, Fabrice Lecuru2, Roman Rouzier3, Noémie Lotersztajn4, Denis Heitz5, Julien Cohen6, Arnaud Fauconnier7, Cyrille Huchon8. 1. Department of Gynecology and Obstetrics, CHI Poissy-Saint-Germain, Poissy, France; University Versailles Saint Quentin en Yvelines, Versailles, 10 rue du Champ Gaillard, 78300 Poissy, France; Department of Gynecologic and Oncologic Surgery, Hôpital Européen Georges Pompidou, AP-HP Paris, University Paris V, René Descartes, 20 rue Leblanc, 75015 Paris, France; Department of Surgery and Senology, Institut Curie, Université Paris V, René Descartes, 26 rue d'Ulm, 75005 Paris, France. Electronic address: myriam.cohen13@gmail.com. 2. Department of Gynecologic and Oncologic Surgery, Hôpital Européen Georges Pompidou, AP-HP Paris, University Paris V, René Descartes, 20 rue Leblanc, 75015 Paris, France. Electronic address: fabrice.lecuru@egp.aphp.fr. 3. Department of Surgery and Senology, Institut Curie, Université Paris V, René Descartes, 26 rue d'Ulm, 75005 Paris, France; EA 7285 Clinical Risks and Safety on Women's Health, University Versailles-Saint-Quentin en Yvelines, France. Electronic address: roman.rouzier@curie.fr. 4. Department of Surgery and Senology, Institut Curie, Université Paris V, René Descartes, 26 rue d'Ulm, 75005 Paris, France. Electronic address: noeloter@hotmail.com. 5. Department of Gynecology and Obstetrics, CHI Poissy-Saint-Germain, Poissy, France; University Versailles Saint Quentin en Yvelines, Versailles, 10 rue du Champ Gaillard, 78300 Poissy, France. Electronic address: dheitz@chi-poissy-st-germain.fr. 6. Medistat, Biostatistics, 10-12 rue de la Conception, 13004 Marseille, France. Electronic address: juliencohen1234@gmail.com. 7. Department of Gynecology and Obstetrics, CHI Poissy-Saint-Germain, Poissy, France; University Versailles Saint Quentin en Yvelines, Versailles, 10 rue du Champ Gaillard, 78300 Poissy, France; EA 7285 Clinical Risks and Safety on Women's Health, University Versailles-Saint-Quentin en Yvelines, France. Electronic address: afauconnier@chi-poissy-st-germain.fr. 8. Department of Gynecology and Obstetrics, CHI Poissy-Saint-Germain, Poissy, France; University Versailles Saint Quentin en Yvelines, Versailles, 10 rue du Champ Gaillard, 78300 Poissy, France; EA 7285 Clinical Risks and Safety on Women's Health, University Versailles-Saint-Quentin en Yvelines, France. Electronic address: chuchon@chi-poissy-st-germain.fr.
Abstract
BACKGROUND: Guidelines recommend re-excision if resection margins are positive in lumpectomy for breast cancer. However, residual disease (RD) is not always found. The aim of our study was to develop a score to predict RD in re-excision specimens. MATERIALS AND METHODS: We carried out a multicenter, retrospective study with two population groups. The 'modeling' group was composed of 148 patients treated in the Centre Hospitalier Poissy-St-Germain or the Georges Pompidou European Hospital and the 'validation' group was composed of 67 patients treated in Curie Institute. The score was built with a logistic regression model. RESULTS: Factors independently associated with RD were: a cumulative length of all positive margins>5 mm, invasion by ductal carcinoma in situ only, a pathological tumor size>30 mm and a pathological tumor size<30 mm with a discrepancy of >50% between pathological and radiological tumor size. The 7-point score allowed the classification of patients into three risk groups for RD: low (16% of patients experienced RD), moderate (65%) and high (100%). The areas under the ROC curve of the score and the logistic model were 0.72(95%CI:0.68-0.75,p = 0.60). The proportion of RD in each group of the validation population (25%, 48%, and 100% in the low, moderate and high group, respectively) confirmed the accuracy of the score in an independent population. CONCLUSIONS: This score enables the identification of patients at high risk of RD but it cannot provide guidance for the decision to undertake re-excision surgery in the low-risk group. Further studies are needed to test the score in extensive datasets and better identify low-risk patients.
BACKGROUND: Guidelines recommend re-excision if resection margins are positive in lumpectomy for breast cancer. However, residual disease (RD) is not always found. The aim of our study was to develop a score to predict RD in re-excision specimens. MATERIALS AND METHODS: We carried out a multicenter, retrospective study with two population groups. The 'modeling' group was composed of 148 patients treated in the Centre Hospitalier Poissy-St-Germain or the Georges Pompidou European Hospital and the 'validation' group was composed of 67 patients treated in Curie Institute. The score was built with a logistic regression model. RESULTS: Factors independently associated with RD were: a cumulative length of all positive margins>5 mm, invasion by ductal carcinoma in situ only, a pathological tumor size>30 mm and a pathological tumor size<30 mm with a discrepancy of >50% between pathological and radiological tumor size. The 7-point score allowed the classification of patients into three risk groups for RD: low (16% of patients experienced RD), moderate (65%) and high (100%). The areas under the ROC curve of the score and the logistic model were 0.72(95%CI:0.68-0.75,p = 0.60). The proportion of RD in each group of the validation population (25%, 48%, and 100% in the low, moderate and high group, respectively) confirmed the accuracy of the score in an independent population. CONCLUSIONS: This score enables the identification of patients at high risk of RD but it cannot provide guidance for the decision to undertake re-excision surgery in the low-risk group. Further studies are needed to test the score in extensive datasets and better identify low-risk patients.
Authors: Julie B Siegel; Rupak Mukherjee; Yeonhee Park; Abbie R Cluver; Catherine Chung; David J Cole; Mark A Lockett; Nancy Klauber-DeMore; Andrea M Abbott Journal: Breast Cancer Res Treat Date: 2021-06-16 Impact factor: 4.872
Authors: François Daoust; Tien Nguyen; Patrick Orsini; Jacques Bismuth; Marie-Maude de Denus-Baillargeon; Israel Veilleux; Alexandre Wetter; Philippe Mckoy; Isabelle Dicaire; Maroun Massabki; Kevin Petrecca; Frédéric Leblond Journal: J Biomed Opt Date: 2021-02 Impact factor: 3.170
Authors: Tasha A Martin; Salman Choudhry; Luther H Holton; W Charles Mylander; Lorraine Tafra; Wen Liang; Rubie Sue Jackson Journal: Plast Reconstr Surg Glob Open Date: 2022-09-23