Analysis of risk factors for non-radical excision in patients with primary breast cancer undergoing breast conserving therapy: A single-center study

Abstract

Introduction: Incomplete excision of the primary lesion is one of the most important causes of local recurrence in breast cancer patients undergoing breast conserving therapy (BCT). The aim of the study is to determine the factors that increase the risk of obtaining positive surgical margins after BCT. Material/Methods: Prospective analysis included 1,102 cases of invasive primary breast cancer treated with BCT (01/2015-12/2016). In the study group, we selected clinical-pathological factors, which have an impact on the excision rate of the primary lesion. It concerned identifiable features in pre-operative diagnostic procedures. Results: In 15.7% of patients after BCT, positive margins of primary tumor excision were obtained. These patients required secondary surgery (with conversion to mastectomy in 78 (45.1%) patients undergoing surgery). In other cases, the primary tumor was excised radically. Non-radical excision of the tumor was recorded in 21.4% of patients presenting lobular breast cancer (vs 7.4% in case of different histopathological types), lesions exceeding value of 2 cm and in event of positive HER2 receptor status (16.8% vs 11.4%). Among factors significantly increasing the rate of non-radical BCT operations, patients’ age and BMI (body mass index) value were specified (in uni- and multivariate analysis, with presence of statistically significant differences in case of every above mentioned factors). Conclusions: Several clinical and pathological factors contribute to significantly increased risk of the incomplete excision following BCT. Identification of such variables should influence the selection of the surgical method. It concerns especially risk factors, which presence is possible to record prior to surgical procedure.