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Vanni G, Pellicciaro M, Renelli G, Materazzo M, Sadri A, Marsella VE, Tacconi F, Bastone SA, Longo B, Di Mauro G, Cervelli V, Berretta M, Buonomo OC. Cavity Shave Margins in Breast Conservative Surgery a Strategy to Reduce Positive Margins and Surgical Time. Curr Oncol 2024; 31:511-520. [PMID: 38248120 PMCID: PMC10814307 DOI: 10.3390/curroncol31010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
Background: Resection of additional tissue circumferentially around the cavity left by lumpectomy (cavity shave) was suggested to reduce rates of positive margins and re-excision. Methods: A single center retrospective study which analyzed margins status, re-excision, and surgical time in patients who underwent breast conserving surgery and cavity shave or intraoperative evaluation of resection margins. Results: Between 2021 and 2023, 594 patients were enrolled in the study. In patients subjected to cavity shave, a significant reduction in positive, focally positive, or closer margins was reported 8.9% vs. 18.5% (p = 0.003). No difference was reported in terms of surgical re-excision (p < 0.846) (5% vs. 5.5%). Surgical time was lower in patients subjected to cavity shave (<0.001). The multivariate analysis intraoperative evaluation of sentinel lymph node OR 1.816 and cavity shave OR 2.909 were predictive factors for a shorter surgical time. Excluding patients subjected to intraoperative evaluation of sentinel lymph node and patients with ductal carcinoma in situ, patients that underwent the cavity shave presented a reduced surgical time (67.9 + 3.8 min vs. 81.6 + 2.8 min) (p = 0.006). Conclusions: Cavity shaving after lumpectomy reduced the rate of positive margins and it was associated with a significant reduction in surgical time compared to intraoperative evaluation of resection margins.
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Affiliation(s)
- Gianluca Vanni
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (G.R.); (M.M.); (V.E.M.); (B.L.); (O.C.B.)
| | - Marco Pellicciaro
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (G.R.); (M.M.); (V.E.M.); (B.L.); (O.C.B.)
- PhD Program in Applied Medical-Surgical Sciences, Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy;
| | - Giulia Renelli
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (G.R.); (M.M.); (V.E.M.); (B.L.); (O.C.B.)
| | - Marco Materazzo
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (G.R.); (M.M.); (V.E.M.); (B.L.); (O.C.B.)
- PhD Program in Applied Medical-Surgical Sciences, Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy;
| | - Amir Sadri
- Plastic Surgery, Great Ormond Hospital for Children NHS Foundation Trust, London WC1N3JH, UK;
| | - Valentina Enrica Marsella
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (G.R.); (M.M.); (V.E.M.); (B.L.); (O.C.B.)
| | - Federico Tacconi
- Unit of Thoracic Surgery, Department of Surgical Sciences, Tor Vergata University, 00133 Rome, Italy;
| | - Sebastiano Angelo Bastone
- PhD Program in Applied Medical-Surgical Sciences, Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy;
- Unit of Thoracic Surgery, Department of Surgical Sciences, Tor Vergata University, 00133 Rome, Italy;
| | - Benedetto Longo
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (G.R.); (M.M.); (V.E.M.); (B.L.); (O.C.B.)
- Plastic and Reconstructive Surgery at Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy;
| | - Giordana Di Mauro
- Medical Oncology Unit, Department of Human Pathology “G. Barresi”, University of Messina, 98122 Messina, Italy;
| | - Valerio Cervelli
- Plastic and Reconstructive Surgery at Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy;
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Oreste Claudio Buonomo
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (G.R.); (M.M.); (V.E.M.); (B.L.); (O.C.B.)
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Iwai Y, Prigoff JG, Sun L, Wiechmann L, Taback B, Rao R, Ugras SK. Shaves off the Cavity or Specimen in Lumpectomy for Breast Cancer. J Surg Res 2022; 277:296-302. [DOI: 10.1016/j.jss.2022.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/08/2022] [Accepted: 04/07/2022] [Indexed: 11/24/2022]
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