Resection of Cavity Shave Margins in Stage 0-III Breast Cancer Patients Undergoing Breast Conserving Surgery: A Prospective Multicenter Randomized Controlled Trial.
| Title: | Resection of Cavity Shave Margins in Stage 0-III Breast Cancer Patients Undergoing Breast Conserving Surgery: A Prospective Multicenter Randomized Controlled Trial. |
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| Authors: | Dupont E; Watson Clinic, Lakeland, FL.; Tsangaris T; Thomas Jefferson University, Philadelphia, PA.; Garcia-Cantu C; Doctors Hospital at Renaissance, Edinburg, TX.; Howard-McNatt M; Wake Forest University, Winston-Salem, NC.; Chiba A; Wake Forest University, Winston-Salem, NC.; Berger AC; Thomas Jefferson University, Philadelphia, PA.; Levine EA; Wake Forest University, Winston-Salem, NC.; Gass JS; Women and Infants Hospital, Providence, RI.; Gallagher K; University of North Carolina, Chapel Hill, NC.; Lum SS; Loma Linda University, Loma Linda, CA.; Martinez RD; Doctors Hospital at Renaissance, Edinburg, TX.; Willis AI; Thomas Jefferson University, Philadelphia, PA.; Pandya SV; Women and Infants Hospital, Providence, RI.; Brown EA; Beaumont Hospital, Troy, MI.; Fenton A; Cleveland Clinic Akron General, Akron, OH.; Mendiola A; Cleveland Clinic Akron General, Akron, OH.; Murray M; Cleveland Clinic Akron General, Akron, OH.; Solomon NL; Loma Linda University, Loma Linda, CA.; Senthil M; Loma Linda University, Loma Linda, CA.; Ollila DW; University of North Carolina, Chapel Hill, NC.; Edmonson D; Women and Infants Hospital, Providence, RI.; Lazar M; Thomas Jefferson University, Philadelphia, PA.; Namm JP; Loma Linda University, Loma Linda, CA.; Li F; Yale University, New Haven, CT.; Butler M; Yale University, New Haven, CT.; McGowan NE; Watson Clinic, Lakeland, FL.; Herrera ME; Doctors Hospital at Renaissance, Edinburg, TX.; Avitan YP; University of North Carolina, Chapel Hill, NC.; Yoder B; MicroPath Laboratories, Lakeland, FL.; Walters LL; Beaumont Hospital, Troy, MI.; McPartland T; Yale University, New Haven, CT.; Chagpar AB; Yale University, New Haven, CT. |
| Source: | Annals of surgery [Ann Surg] 2021 May 01; Vol. 273 (5), pp. 876-881. |
| Publication Type: | Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print Cited Medium: Internet ISSN: 1528-1140 (Electronic) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins |
| MeSH Terms: | Margins of Excision* ; Neoplasm Staging*; Breast Neoplasms/*surgery ; Mastectomy, Segmental/*methods; Breast Neoplasms/diagnosis ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Prospective Studies ; Treatment Outcome |
| Abstract: | Objective: Single-center studies have demonstrated that resection of cavity shave margins (CSM) halves the rate of positive margins and re-excision in breast cancer patients undergoing partial mastectomy (PM). We sought to determine if these findings were externally generalizable across practice settings.; Methods: In this multicenter randomized controlled trial occurring in 9 centers across the United States, stage 0-III breast cancer patients undergoing PM were randomly assigned to either have resection of CSM ("shave" group) or not ("no shave" group). Randomization occurred intraoperatively, after the surgeon had completed their standard PM. Primary outcome measures were positive margin and re-excision rates.; Results: Between July 28, 2016 and April 13, 2018, 400 patients were enrolled in this trial. Four patients (2 in each arm) did not meet inclusion criteria after randomization, leaving 396 patients for analysis: 196 in the "shave" group and 200 to the "no shave" group. Median patient age was 65 years (range; 29-94). Groups were well matched at baseline for demographic and clinicopathologic factors. Prior to randomization, positive margin rates were similar in the "shave" and "no shave" groups (76/196 (38.8%) vs. 72/200 (36.0%), respectively, P = 0.604). After randomization, those in the "shave" group were significantly less likely than those in the "no shave" group to have positive margins (19/196 (9.7%) vs. 72/200 (36.0%), P < 0.001), and to require re-excision or mastectomy for margin clearance (17/196 (8.7%) vs. 47/200 (23.5%), P < 0.001).; Conclusion: Resection of CSM significantly reduces positive margin and re-excision rates in patients undergoing PM.; (Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.) |
| Competing Interests: | The authors report no conflicts of interest. |
| Comments: | Comment in: Ann Surg. 2022 Dec 1;276(6):e1117. doi: 10.1097/SLA.0000000000005279.. (PMID: 35129492); Comment in: Ann Surg. 2022 Dec 1;276(6):e1117-e1118. doi: 10.1097/SLA.0000000000005280.. (PMID: 35129493) |
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| Entry Date(s): | Date Created: 20190711 Date Completed: 20210524 Latest Revision: 20221210 |
| Update Code: | 20260130 |
| DOI: | 10.1097/SLA.0000000000003449 |
| PMID: | 31290763 |
| Database: | MEDLINE |
Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't