TY - JOUR
T1 - Does every woman presenting with malignant calcifications require a post lumpectomy mammogram?
AU - Rodrigues-Duarte, Halio
AU - van Nijnatten, Thiemo J. A.
AU - Khoury, Tatiana
AU - Cody, Hiram
AU - Jacobs, Stefanie
AU - Jochelson, Maxine S.
N1 - Funding Information:
Funding This study was funded by the NIH/NCI Cancer Center Support Grant P30 CA008748 and a Grant from the Breast Cancer Research Foundation.
Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2019/7
Y1 - 2019/7
N2 - PurposeSuccessful breast-conserving surgery (BCS) followed by radiation therapy (XRT) is dependent on complete removal of the cancer with clear surgical margins, providing survival rates equivalent to those observed following mastectomy. In patients who have cancers presenting with microcalcifications, post lumpectomy mammograms (PLM) prior to radiation (XRT) can be performed to ensure that no cancer has been left behind. The purpose of this study was to assess the benefit of PLM in patients with malignant breast tumors presenting with microcalcifications.MethodsIn this IRB-approved retrospective study, we reviewed medical records for patients with breast cancers presenting with microcalcifications who underwent BCS between February 2008 and June 2013. 198 patients who had a PLM prior to XRT for cancers presenting with microcalcifications were included.ResultsHistopathology of the initial lumpectomy revealed invasive carcinoma in 78/198 (39.4%) and DCIS alone in 120/198 (60.6%). 114/198 (58%) patients had negative surgical margins. 7/114 (6%) patients with negative margins had positive PLM and re-excisions that were positive for malignancy: sensitivity 88%, specificity 95%, PPV 58%, NPV 99%. 84/198 patients had positive surgical margins. The diagnostic performance of PLM in this group was: sensitivity 55%, specificity 71%, PPV 66%, NPV 61%.ConclusionPLM plays an important role in the evaluation of patients undergoing breast conservation for breast cancer presenting with microcalcifications. Residual malignancy was detected on positive PLM in 6% of patients with negative margins.
AB - PurposeSuccessful breast-conserving surgery (BCS) followed by radiation therapy (XRT) is dependent on complete removal of the cancer with clear surgical margins, providing survival rates equivalent to those observed following mastectomy. In patients who have cancers presenting with microcalcifications, post lumpectomy mammograms (PLM) prior to radiation (XRT) can be performed to ensure that no cancer has been left behind. The purpose of this study was to assess the benefit of PLM in patients with malignant breast tumors presenting with microcalcifications.MethodsIn this IRB-approved retrospective study, we reviewed medical records for patients with breast cancers presenting with microcalcifications who underwent BCS between February 2008 and June 2013. 198 patients who had a PLM prior to XRT for cancers presenting with microcalcifications were included.ResultsHistopathology of the initial lumpectomy revealed invasive carcinoma in 78/198 (39.4%) and DCIS alone in 120/198 (60.6%). 114/198 (58%) patients had negative surgical margins. 7/114 (6%) patients with negative margins had positive PLM and re-excisions that were positive for malignancy: sensitivity 88%, specificity 95%, PPV 58%, NPV 99%. 84/198 patients had positive surgical margins. The diagnostic performance of PLM in this group was: sensitivity 55%, specificity 71%, PPV 66%, NPV 61%.ConclusionPLM plays an important role in the evaluation of patients undergoing breast conservation for breast cancer presenting with microcalcifications. Residual malignancy was detected on positive PLM in 6% of patients with negative margins.
KW - Mammography
KW - Breast cancer
KW - Breast conservative therapy
KW - Radiation therapy
KW - CARCINOMA-IN-SITU
KW - BREAST-CONSERVING SURGERY
KW - POSTEXCISION
KW - MANAGEMENT
KW - RADIATION
U2 - 10.1007/s10549-019-05246-4
DO - 10.1007/s10549-019-05246-4
M3 - Article
C2 - 31006105
SN - 0167-6806
VL - 176
SP - 401
EP - 406
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 2
ER -