Impact of Atypical Hyperplasia at Surgical Margins on breast cancer outcomes in patients treated with neoadjuvant chemotherapy

Frontiers in Oncology

Oncology

Jing Zhang¹  An Su²  Haoshi Bao²  Yaping Yang²  Heran Deng²  Zhou He²  Jieqiong Liu²  Jiannan Wu² 

[1] Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China;Anesthesiology Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China;Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China;Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China;

关键词: atypical hyperplasia;    surgical margins;    ipsilateral breast tumor recurrence;    neoadjuvant chemotherapy;    breast-conserving surgery;   

DOI  :  10.3389/fonc.2023.1202689

 received in 2023-04-09, accepted in 2023-05-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundWomen with atypical hyperplasia (AH) is associated with a higher risk of future breast cancer. However, whether AH found at margins in patients with breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC) needs re-excision is not well-defined. The aim of the present study was to evaluate the impact of AH at the surgical margins on the local recurrence and survival outcomes in breast cancer patients treated with NAC and BCS.MethodsA retrospective analysis comparing patients who treated with NAC and BCS with AH at the margins to those without AH was performed.Results598 patients were included in this study. The 5-year rates of ipsilateral breast tumor recurrence (IBTR) were 4.6% and 6.2% in patients with and without AH, respectively. No significant differences were observed among the two groups in terms of IBTR, DMFS, or OS. HER2 overexpressing breast cancer patients with severe AH at margins have a significantly higher risk of IBTR compared to those without severe AH.ConclusionOur study suggests that the presence of AH at the surgical margins of BCS in patients who received NAC does not appear to increase the risk of ipsilateral breast cancer. Therefore, there is no need for surgeons to routinely perform additional re-excision of AH found at the margins of BCS in these patients. However, selective re-excision should be considered in certain cases, particularly in patients with HER2 overexpression.

【 授权许可】

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Copyright © 2023 Su, Zhang, Liu, Yang, He, Bao, Deng and Wu