Impact of Marging Shaving on Re-Excision rates in patients with primary invasive carcinoma and carcinoma in situ in Breast Conserving Surgery. Data from a population based cohort of clinical cancer registry

Background Previous studies reported considerably high re-excision rates in breast-conserving surgery (BCS) about 20 %.

Circumferencial Marging Shaving (CMS) could be a surgical strategy to reduce re-excision rates. This study aimed to investigate the effects of CMS during BCS on reducing residual tumor.

Methods Totally, 440 patients with primary carcinoma or carcinoma in situ of the breast who underwent BCS in the University Medical Center Regensburg between 2017 and 2019 were analyzed. Patients who had CMS or targeted re-excision depending on intraoperative

mammography or sonography were compared with patients receiving BCS without removal of further tissue during primary surgery. The impact of these surgical methods on residual tumor (R1) and further necessary intervention was analyzed by means of multivariable

binary logistic regression model adjusting for tumor size, nodal status, histological type, tumor biology, neoadjuvant chemotherapy, surgeon, breast side, and patient´s age.

Results A total of 306 patients had invasive-ductal carcinoma. Of these, 40 patients received CMS, 82 targeted intraoperative re-excision, and 184 patients no further excision. After comparing these sub-groups in a binary regression model there was a tendency for CMS and targeted intraoperative re-excision to have advantage over missing re-excision regarding residual tumor. Furthermore, after adjusting for different variables, specially patients with T1-tumors had a slightly significant benefit from CMS.

Conclusion Our results indicate a tendency that CMS reduces residual tumor compared to targeted intraoperative re-excisions or to no further surgical action, although final results will be presented.

Publication History

Article published online:
07 October 2020