Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, 610 University Ave., Suite 3-130, Toronto, Ontario, Canada M5G 2M9.
Am J Surg. 2012 Sep;204(3):263-8. doi: 10.1016/j.amjsurg.2012.03.007. Epub 2012 Jul 12.
The purpose of this study was to identify factors that predict an increased risk of a positive surgical margin after breast-conserving therapy for nonpalpable carcinoma of the breast.
In this prospective study, 305 patients with nonpalpable invasive breast cancer or ductal carcinoma in situ were identified and underwent localization lumpectomy. Patient, technical, and tumor factors with a potential to predict margin status were documented.
A 20% positive margin rate was observed. Univariate analysis of patient, tumor, and technical factors revealed that localizations performed under stereotactic guidance (P < .001), presence of in situ disease, high tumor grade, larger tumor size, multifocal disease, and presence of mammographic microcalcifications (P < .02) were predictive of positive margins. With the exception of tumor grade and mammographic microcalcifications, multivariable analysis identified the same factors.
This study identified several factors associated with positive margins that should be considered when planning breast-conserving therapy for nonpalpable tumors.
本研究旨在确定预测非触诊性乳腺癌保乳治疗后切缘阳性的风险增加的因素。
在这项前瞻性研究中，确定了 305 例非触诊性浸润性乳腺癌或导管原位癌患者，并进行了定位保乳切除术。记录了可能预测边缘状态的患者、技术和肿瘤因素。
观察到 20%的阳性切缘率。对患者、肿瘤和技术因素的单因素分析显示，在立体定向引导下进行定位（P<.001）、原位疾病存在、高肿瘤分级、较大肿瘤大小、多灶性疾病和存在乳腺微钙化（P<.02）与阳性切缘相关。除肿瘤分级和乳腺微钙化外，多变量分析还确定了相同的因素。
本研究确定了与阳性切缘相关的几个因素，在计划非触诊性肿瘤的保乳治疗时应考虑这些因素。
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