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首页> 外文期刊>International Journal of Surgical Oncology >Higher Volume at Time of Breast Conserving Surgery Reduces Re-Excision in DCIS
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Higher Volume at Time of Breast Conserving Surgery Reduces Re-Excision in DCIS

机译：保留乳房的手术时体积更大，减少了DCIS的再切除

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Purpose. The purpose of this study was to compare the surgical and pathological variables which impact rate of re-excision following breast conserving therapy (BCS) with or without concurrent additional margin excision (AM).Methods. The pathology database was queried for all patients with DCIS from January 2004 to September 2008. Pathologic assessment included volume of excision, subtype, size, distance from margin, grade, necrosis, multifocality, calcifications, and ER/PR status.Results. 405 cases were identified and 201 underwent BCS, 151-BCS-AM, and 53-mastectomy. Among the 201 BCS patients, 190 underwent re-excision for close or involved margins. 129 of these were treated with BCS and 61 with BCS-AM (P<.0001). The incidence of residual DCIS in the re-excision specimens was 32% (n=65) for BCS and 22% (n=33) for BCS-AM (P<.05). For both the BCS and the BCS-AM cohorts, volume of tissue excised is inversely correlated to the rate of re-excision (P=.0284). Multifocality (P=.0002) and ER status (P=.0382) were also significant predictors for rate of re-excision and variation in surgical technique was insignificant.Conclusions.The rate of positive margins, re-excision, and residual disease was significantly higher in patients with lower volume of excision. The performance of concurrent additional margin excision increases the efficacy of BCS for DCIS.
机译：目的。这项研究的目的是比较外科手术和病理学变量，这些变量会影响在有或没有同时进行额外切缘切除术（AM）的情况下进行保乳治疗（BCS）后再切除的率。查询2004年1月至2008年9月所有DCIS患者的病理数据库。病理评估包括切除量，亚型，大小，距边缘的距离，等级，坏死，多灶性，钙化以及ER / PR状态。鉴定出405例，其中201例接受了BCS，151-BCS-AM和53例乳房切除术。在201例BCS患者中，有190例因边缘狭窄或边缘受累而再次切除。其中129例接受BCS治疗，61例接受BCS-AM治疗（P <.0001）。再切除标本中残留的DCIS发生率，BCS为32％（n = 65），BCS-AM为22％（n = 33）（P <.05）。对于BCS和BCS-AM队列，切除的组织体积与再切除率成反比（P = .0284）。多灶性（P = .0002）和ER状态（P = .0382）也是再次切除率的重要预测指标，而手术技术的变化也无关紧要。结论。阳性切缘，再次切除率和残留疾病的发生率是切除量较低的患者明显更高。同时进行的额外切缘切除术的性能提高了BCS对DCIS的疗效。

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