Does breast density increase the risk of re-excision for women with breast cancer having breast-conservation therapy? Journal Article


Authors: Walsh, S. M.; Brennan, S. B.; Zabor, E. C.; Rosenberger, L. H.; Stempel, M.; Lebron-Zapata, L.; Gemignani, M. L.
Article Title: Does breast density increase the risk of re-excision for women with breast cancer having breast-conservation therapy?
Abstract: Background: Women with dense breasts may have less-accurate preoperative evaluation of extent of disease, potentially affecting the achievement of negative margins. The goal of this study is to examine the association between breast density and re-excision rates in women having breast-conserving surgery for invasive breast cancer. Patients and Methods: Women with stage I/II invasive breast cancer treated with breast-conserving surgery between 1/1/2014 and 10/31/2014 were included. Breast density was assessed by two radiologists. The association between breast density and re-excision was examined using logistic regression. Results: Seven hundred and one women were included. Overall, 106 (15.1%) women had at least one re-excision. Younger age at diagnosis was associated with increased breast density (p < 0.001). On univariable analysis, increased breast density was associated with significantly increased odds of re-excision (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.04–1.83), as was multifocal disease, human epidermal growth factor receptor 2 (HER2) positive status, and extensive intraductal component (EIC) (all p < 0.05). On multivariable analysis, breast density remained significantly associated with increased odds of re-excision (OR 1.37, 95% CI 1.00–1.86), as did multifocality and EIC. HER2 positive status was not significantly associated with re-excision on multivariable analysis. Conclusions: Women with dense breasts are more likely to need additional surgery (re-excision after breast-conserving surgery), but increased breast density did not adversely affect disease-free survival in our study. Our findings support the need for further study in developing techniques that can help decrease re-excisions for women with dense breasts who undergo breast-conserving surgery. © 2019, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 26
Issue: 13
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2019-12-01
Start Page: 4246
End Page: 4253
Language: English
DOI: 10.1245/s10434-019-07647-7
PUBMED: 31396783
PROVIDER: scopus
PMCID: PMC6868322
DOI/URL:
Notes: Article -- Export Date: 2 December 2019 -- Source: Scopus
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MSK Authors
  1. Mary L Gemignani
    157 Gemignani
  2. Emily Craig Zabor
    156 Zabor
  3. Sandra B Brennan
    29 Brennan
  4. Michelle Moccio Stempel
    147 Stempel
  5. Siun M Walsh
    5 Walsh