The authors do not have conflicts of interest. There are no sources of funding and no commercial interest.
Indication for relumpectomy—a useful scoring system in cases of invasive breast cancer†
Article first published online: 20 JUL 2011
Copyright © 2011 Wiley Periodicals, Inc.
Journal of Surgical Oncology
Volume 105, Issue 4, pages 376–380, 15 March 2012
How to Cite
Halevy, A., Lavy, R., Pappo, I., Davidson, T., Gold-Deutch, R., Jeroukhimov, I., Shapira, Z., Wassermann, I., Sandbank, J. and Chikman, B. (2012), Indication for relumpectomy—a useful scoring system in cases of invasive breast cancer. J. Surg. Oncol., 105: 376–380. doi: 10.1002/jso.22027
- Issue published online: 6 FEB 2012
- Article first published online: 20 JUL 2011
- Manuscript Accepted: 20 JUN 2011
- Manuscript Received: 19 JAN 2011
- breast cancer;
- scoring system
Background and Objectives
In two-thirds of breast cancer patients undergoing reoperation no residual tumor will be found. A scoring system for selection of patients who might benefit from relumpectomy is proposed.
This study is based on 293 patients with invasive breast cancer undergoing reoperation due to margins of <2 mm. Eighteen parameters were evaluated by univariate and multivariate stepwise logistic regression.
Univariate analysis identified nine parameters associated with a residual invasive tumor: surgical margins; lobular histological type; grade 3; multifocality; positive lymph modes; non-fine needle localization (FNL) versus FNL lumpectomy; vascular/lymphatic invasion; age <50 years; and tumor size ≥3 cm. Multivariate stepwise logistic regression study identified six out of nine parameters associated with a higher probability of finding a residual invasive tumor: margins <1 mm, multifocality, tumor size ≥3 cm, positive lymph nodes, age <50 years, and lumpectomy without previous FNL. Odds of these factors were used for scoring.
For patients with surgical margins <2 mm and a score of <4, the probability of finding a residual invasive tumor is 0%, while the probability of finding a microfocus of <2 mm of invasive carcinoma is 3.2% and of finding residual DCIS is up to 10%. J. Surg. Oncol. 2012;105:376–380. © 2011 Wiley Periodicals, Inc.