What is an adequate margin for breast-conserving surgery? Surgeon attitudes and correlates.
What is an adequate margin for breast-conserving surgery? Surgeon attitudes and correlates.
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DOI：
10.1245/s10434-009-0765-1
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发表时间：
2010-02
影响因子：
3.7
通讯作者：
Morrow M
中科院分区：
文献类型：
--
作者：
Azu M;Abrahamse P;Katz SJ;Jagsi R;Morrow M
Re-excision is common in BCS, in part due to lack of consensus on margin definitions. A population-based sample of surgeons was used to determine current attitudes toward margin width and identify characteristics associated with margin choice. Breast cancer patients treated from 2005–2007 were identified from the L.A. and Detroit SEER registries. Pathology reports were used to identify their surgeons, who were surveyed (n = 418). Response rate was 74.6% (n = 312). Mean surgeon age was 51.9 years, 17.8% were female, and the mean number of years in practice was 18.5. Wide variation in margin selection was noted among surgeons, and did not differ for invasive cancer and DCIS plus radiotherapy. In a T1 invasive cancer scenario, 11% of surgeons endorsed margins of tumor not touching ink (TNTI), 42% of 1–2mm, 28% of ≥5mm, and 19% >1cm as precluding re-excision. On multivariate analysis, having 50% or more of practice devoted to breast cancer independently predicted smaller margin choice (p=0.03). For a patient with a 1.4cm grade 2 ER positive DCIS without RT planned, 3% of surgeons chose TNTI, 12% 1– 2mm, 25% ≥5mm, and 61% >1cm as precluding re-excision. Breast specialization independently predicted larger margin choice (p=0.03). Gender and years in practice were not predictive of margin choice. Wide variation in BCS margin definition exists. Variation is similar for invasive cancer and DCIS with RT, with more specialized surgeons choosing smaller margins. In DCIS without RT, more specialized surgeons favored larger margins. A standardized margin definition may significantly affect re-excision rates.
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影响因子：
3
作者：
Singletary, SE
通讯作者：
Singletary, SE
影响因子：
5.7
作者：
Poortman, Philip M.;Collette, Laurence;Bartelink, Harry
通讯作者：
Bartelink, Harry
影响因子：
45.3
作者：
Bijker, Nina;Meijnen, Philip;Rutgers, Emiel J. Th.
通讯作者：
Rutgers, Emiel J. Th.
影响因子：
6.3
作者：
Rockwood, TH;Sangster, RL;Dillman, DA
通讯作者：
Dillman, DA
影响因子：
45.3
作者：
Wong, JS;Kaelin, CM;Smith, BL
通讯作者：
Smith, BL