Does non-classic lobular carcinoma in situ at the lumpectomy margin increase local recurrence? Journal Article
| Authors: | Beck, A. C.; Bayard, S.; Plitas, G.; Sevilimedu, V.; Kuba, M. G.; Garcia, P.; Morrow, M.; Tadros, A. B. |
| Article Title: | Does non-classic lobular carcinoma in situ at the lumpectomy margin increase local recurrence? |
| Abstract: | Background: The clinical significance of nonclassic, lobular carcinoma in situ (NC-LCIS) at the surgical margin of excisions for invasive cancer is unknown. We sought to determine whether NC-LCIS at or near the margin in the setting of a concurrent invasive carcinoma is associated with risk of ipsilateral breast tumor recurrence (IBTR) and locoregional recurrence (LRR). Methods: Patients with stage 0-III breast cancer and NC-LCIS who underwent lumpectomy between January 2010 and January 2022 at a single institution were retrospectively identified. NC-LCIS margins were stratified as <2 mm, ≥2 mm, or within shave margin. Rates of IBTR and LRR were examined. Results: A total of 511 female patients (median age 60 years [interquartile range (IQR) 52–69]) with NC-LCIS and an associated ipsilateral breast cancer with a median follow-up of 3.4 years (IQR 2.0–5.9) were identified. Final margins for NC-LCIS were ≥2 mm in 348 patients (68%), <2 mm in 37 (7.2%), and within shave margin in 126 (24.6%). Crude incidence of IBTR was 3.3% (n = 17) and that of LRR was 4.9% (n = 25). There was no difference in the crude rate of IBTR by NC-LCIS margin status (IBTR rate: 3.7% ≥2 mm, 0% <2 mm, 3.2% within shave margin, p = 0.8) nor in LRR (LRR rate: 4.9% ≥2 mm, 2.7% <2 mm, 5.6% within shave margin, p = 0.9). Conclusions: For completely excised invasive breast cancers associated with NC-LCIS, extent of margin width for NC-LCIS was not associated with a difference in IBTR or LRR. These data suggest that the decision to perform reexcision of margin after lumpectomy should be driven by the invasive cancer, rather than the NC-LCIS margin. © 2023, Society of Surgical Oncology. |
| Keywords: | adult; controlled study; aged; middle aged; retrospective studies; major clinical study; cancer patient; cancer staging; recurrence risk; follow up; cancer incidence; neoplasm recurrence, local; breast cancer; cohort analysis; pathology; breast neoplasms; retrospective study; tumor recurrence; breast tumor; carcinoma in situ; partial mastectomy; epidemiology; mastectomy, segmental; ductal carcinoma in situ; lumpectomy; re-excision; lobular carcinoma in situ; carcinoma, lobular; surgical margin; local recurrence; lobular carcinoma; margin width; invasive breast cancer; humans; human; female; article; breast carcinoma in situ; breast cancer recurrence |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 30 |
| Issue: | 10 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2023-10-01 |
| Start Page: | 6061 |
| End Page: | 6069 |
| Language: | English |
| DOI: | 10.1245/s10434-023-13899-1 |
| PUBMED: | 37493892 |
| PROVIDER: | scopus |
| PMCID: | PMC10967654 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in PubMed and PDF -- Corresponding author is MSK author: Audree B. Tadros -- Source: Scopus |
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