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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

CAMARILLO-QUESADA, Argelia Elisa; MAYTORENA-CORDOVA, German; OLGUIN-CRUCES, Víctor Alberto  and  COUTINO-RUIZ, Maritza Guadalupe. Factors associated with positive surgical margins in breast cancer patients treated with conservative surgery. Ginecol. obstet. Méx. [online]. 2021, vol.89, n.9, pp.696-703.  Epub Apr 04, 2022. ISSN 0300-9041.  https://doi.org/10.24245/gom.v89i9.5892.

OBJECTIVE:

To know the factors associated with positive surgical edges in breast cancer patients treated with conservative surgery.

MATERIALS AND METHODS:

Descriptive-observational, comparative, retrospective and cross-sectional study, performed between January 1, 2018 and April 30, 2019 at the Unidad Médica de Alta Especialidad Hospital de Ginecoobstetricia 4 Luis Castelazo Ayala. Inclusion criteria: patients diagnosed with breast cancer operated with conservative surgery and with complete histopathological and immunohistochemical report.Exclusion criteria: patients with breast cancer treated outside the unit, with other types of neoplasms (lymphomas, sarcomas) and in advanced clinical stage or neoadjuvant treatment. Elimination criteria: patients with incomplete histopathological report and without clinical records in the unit. The statistical analysis was processed in SPSS version 25. The bivariate analysis studied the relationship between the variables by means of the 2&apos;s test. For all tests, values < 0.05 were considered statistically significant.

RESULTS:

153 cases were analyzed; of these 11 were patients with a positive surgical edge in the definitive report, corresponding to 7.18% of the total number of breast-conserving surgeries performed in the study period. These patients required another surgical intervention, 6 of them in margin enlargement and the remaining 5 in total mastectomy. There was a statistically significant relationship between non-palpable lesions and positive surgical margin (p < 0.003). Of the rest of the variables studied, no relationship with statistical significance was found.

CONCLUSIONS:

The factors associated with positive margins were size 11 to 20 mm in 45.4%, age 58 ± 11.9 years in 72.7%, multifocality in 63.6%, lymphovascular invasion in 63.6%, ductal carcinoma subtype in 72.7%, histologic grade 2 in 72.7%, luminal molecular classification A with 72.7% and nonpalpable lesion with 54.5%.

Keywords : Breast cancer; Mastectomy; Lymphomas; Sarcomas; Neoadjuvant treatment; Breast conserving surgeries; Margin; Total mastectomy; Positive surgical margin; Ductal carcinoma; Luminal.

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