Piero Fregatti1,2, Marco Gipponi3, Raquel Diaz2, Raffaele DE Rosa1, Federica Murelli1,2, Francesca Depaoli4, Francesca Pitto5, Ilaria Baldelli1,6, Gabriele Zoppoli1,7, Marcello Ceppi8, Daniele Friedman1,2. 1. School of Medicine, University of Genoa, Genoa, Italy. 2. Breast Surgery Clinic, San Martino Policlinic Hospital, Genoa, Italy. 3. Breast Surgery Clinic, San Martino Policlinic Hospital, Genoa, Italy marco.gipponi@hsanmartino.it. 4. Breast Unit, ASL3, Genoa, Italy. 5. Pathology Unit, San Martino Policlinic Hospital, Genoa, Italy. 6. Plastic Surgery, San Martino Policlinic Hospital, Genoa, Italy. 7. Department of Internal Medicine, San Martino Policlinic Hospital, Genoa, Italy. 8. Biostatistics Unit, San Martino Policlinic Hospital, Genoa, Italy.
Abstract
BACKGROUND/AIM: The histopathological assessment of the B5c category may sometimes be hampered by simple artifacts that may lead to over- or underestimation of that particular breast cancer so that its management is still controversial, especially with regard to the decision to proceed immediately to sentinel lymph node (SLN) biopsy. Hence, a retrospective study was performed in 174 patients undergoing breast-conserving surgery with a preoperative diagnosis of B5c in order to assess the usefulness of axillary node staging by means of SLN biopsy. PATIENTS AND METHODS: Pre- and post-operative parameters including imaging data, histology of the primary tumor and SLN biopsy, biological prognostic factors, type of operation, and adjuvant regimens were computed. RESULTS: Invasive carcinoma and carcinoma in situ were diagnosed in 46 (26.5%) and 128 patients (73.5%), respectively. Preoperative tumor size was significantly related to post-operative diagnosis of invasive carcinoma (p=0.020), retaining its predictive value at logistic regression analysis (p=0.046). Post-operative predictive factors of invasion were represented by tumor stage (p=0.008) and grading (p=0.008). CONCLUSION: B5c preoperative diagnosis in patients undergoing breast conservative surgery would suggest an immediate wide local excision avoiding any further preoperative histologic assessment. Conversely, one-stage SLN biopsy might be suggested for patients eligible to mastectomy, similar to patients with carcinoma in situ, although its impact on the therapeutic and prognostic assessment seems negligible. Copyright
BACKGROUND/AIM: The histopathological assessment of the B5c category may sometimes be hampered by simple artifacts that may lead to over- or underestimation of that particular breast cancer so that its management is still controversial, especially with regard to the decision to proceed immediately to sentinel lymph node (SLN) biopsy. Hence, a retrospective study was performed in 174 patients undergoing breast-conserving surgery with a preoperative diagnosis of B5c in order to assess the usefulness of axillary node staging by means of SLN biopsy. PATIENTS AND METHODS: Pre- and post-operative parameters including imaging data, histology of the primary tumor and SLN biopsy, biological prognostic factors, type of operation, and adjuvant regimens were computed. RESULTS:Invasive carcinoma and carcinoma in situ were diagnosed in 46 (26.5%) and 128 patients (73.5%), respectively. Preoperative tumor size was significantly related to post-operative diagnosis of invasive carcinoma (p=0.020), retaining its predictive value at logistic regression analysis (p=0.046). Post-operative predictive factors of invasion were represented by tumor stage (p=0.008) and grading (p=0.008). CONCLUSION: B5c preoperative diagnosis in patients undergoing breast conservative surgery would suggest an immediate wide local excision avoiding any further preoperative histologic assessment. Conversely, one-stage SLN biopsy might be suggested for patients eligible to mastectomy, similar to patients with carcinoma in situ, although its impact on the therapeutic and prognostic assessment seems negligible. Copyright
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