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Factores asociados con bordes quirúrgicos positivos en pacientes con cáncer de mama tratadas con cirugía conservadora.

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Title: Factores asociados con bordes quirúrgicos positivos en pacientes con cáncer de mama tratadas con cirugía conservadora.
Alternate Title: Factors associated with positive surgical margins in breast cancer patients treated with conservative surgery.
Authors: Elisa Camarillo-Quesada, Argelia1 argelia.camarillo@gmail.com, Maytorena-Córdova, German2, Alberto Olguín-Cruces, Víctor3, Guadalupe Coutiño-Ruiz, Maritza4
Source: Ginecología y Obstetricia de México. Sep2021, Vol. 89 Issue 9, p696-703. 8p.
Subjects: BREAST cancer, SURGICAL margin, BREAST cancer surgery, MASTECTOMY, NEOADJUVANT chemotherapy, DUCTAL carcinoma, SARCOMA
Abstract (English): 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'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 breastconserving 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%. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): OBJETIVO: Conocer los factores asociados con los bordes quirúrgicos positivos en pacientes con cáncer de mama tratadas con cirugía conservadora. MATERIALES Y MÉTODOS: Estudio descriptivo-observacional, comparativo, retrospectivo y transversal efectuado entre el 1 de enero de 2018 y el 30 de abril de 2019 en la Unidad Médica de Alta Especialidad, Hospital de Ginecoobstetricia 4 Luis Castelazo Ayala. Criterios de inclusión: pacientes con diagnóstico de cáncer de mama intervenidas con cirugía conservadora y con reporte histopatológico e inmunohistoquímico completo. Criterios de exclusión: pacientes con cáncer de mama tratadas fuera de la unidad, con otros tipos de neoplasias (linfomas, sarcomas) o en etapa clínica avanzada o tratamiento neoadyuvante. Criterios de eliminación: pacientes con reporte histopatológico incompleto y sin expediente clínico en la unidad. El análisis estadístico se procesó en el programa SPSS versión 25. El análisis bivariado estudió la relación entre las variables por medio de la prueba de X2. Para todas las pruebas, los valores < 0.05 se consideraron con significación estadística. RESULTADOS: Se analizaron 153 casos; de éstos, 11 fueron de pacientes con borde quirúrgico positivo en el reporte definitivo, correspondientes al 7.18% del total de las cirugías conservadoras de mama practicadas en el periodo de estudio. Estas pacientes requirieron reintervención quirúrgica, 6 de ellas para ampliación de márgenes y las 5 restantes mastectomía total. Se observó relación entre las lesiones no palpables y el margen quirúrgico positivo, con significación estadística (p < 0.003). Del resto de las variables estudiadas, no se encontró relación con significación estadística. CONCLUSIONES: Los factores asociados con bordes positivos fueron: tamaño de 11 a 20 mm en un 45.4%, edad 58 ± 11.9 años en un 72.7%, multifocalidad en un 63.6%, invasión linfovascular en un 63.6%, subtipo carcinoma ductal en 72.7%, grado histológico 2 en un 72.7%, clasificación molecular luminal A con un 72.7% y lesión no palpable con un 54.5%. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract: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'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 breastconserving 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%. [ABSTRACT FROM AUTHOR]
ISSN:03009041
DOI:10.24245/gom.v89i9.5892