Morvarid Shirmohammadi,Dimitri Hadjiminas and Rathi Ramakrishnan
Imperial College Healthcare NHS Trust, UK
Posters & Accepted Abstracts: RRJMHS
Introduction: Breast conserving surgery (BCS) remains standard protocol
for managing localized breast cancers (BC). There is no consensus on ‘optimal’
margin width. Association of Breast Surgery (ABS, 2015), deem 1 mm for invasive
cancers (IC) and intraductal carcinoma (DCIS) as adequate while 2018 guidelines
recommends tumour on ink as ‘positive’ margin for IC and DCIS. We reviewed
margin re-excision rate at our centre, a major London University hospital.
Objective: The main objective of the present study is to assess margin revision rate (including completion mastectomy), post BCS; and if our re-excision rate is in line with national average.
Methods: Two years data was collected of patients undergoing BCS between 2017 and 2018. Re-excisions for positive margins and subsequent completion mastectomy, if any, were recorded. Tumour demographic including size and number of positive margins was also noted. We used ABS 2015 as standard.
Results: The results showed that among 303 women undergoing BCS for cancer, 59 (19.4%) underwent further surgery, 42/59 (71/1%) had IC and 17/59 (28.9%) had DCIS. Fifty out of 59 (84.7%) patients underwent re-excision post BCS and 9/59 (15.3%) had completion mastectomy. In patients undergoing completion mastectomy, average tumour size was 42.5 mm. For IC, a median of two margins were positive, while DCIS, median positive rate was marginally higher at three. In comparison with previous data from our centre (AoE; 2015), there appears to be 3.8% reduction (23.2 vs. 19.4) in the re-excision rate.
Conclusion: Our revision rate is 19.4%; in line with national average (17.2%). 15.3% women had completion mastectomy. Risk of positive margin was higher with DCIS than IC.
Morvarid Shirmohammadi has completed her MD from Iran. After years of contribution to medicine, she pursued her interest in Fundamental Research and obtained her MSc in Cellular Biology from University of Paris 5 in 2007. She has published her papers in creditable journals and presented her research in international conferences. She is currently a Histopathology Trainee at Imperial College Healthcare NHS Trust.
E-mail: [email protected]