caa a22 4500 445336048 CHVBK 20180317142755.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1245/s10434-010-1406-4 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1406-4 Inadequate Margins of Excision When Undergoing Mastectomy for Breast Cancer: Which Patients are at Risk? [Elektronische Daten] [Fariha Sheikh, Alanna Rebecca, Barbara Pockaj, Nabil Wasif, Ann McCullough, William Casey, Peter Kreymerman, Richard Gray] Background: We analyzed the margin status and risk factors for inadequate margins among patients who underwent skin-sparing mastectomies (SSM) and traditional total mastectomies (TM). Materials and Methods: Patients undergoing mastectomies from 2003 to 2009 were included. Margins of excision were considered positive if carcinoma was at an inked margin and were considered close if such disease was within 2mm of an inked margin. Results: A total of 426 patients were identified. The mean age was 60years and 90% were white. Mean tumor size was 2.6cm and 44% had multiple ipsilateral carcinomas. Of 426 patients, 177 (42%) underwent SSM with reconstruction and 249 (58%) TM. The rate of positive or close margins on the initial specimen was 29% for SSM vs. 12% for TM (P<0.01), and the rate of reoperation for margins was 7% for SSM vs. 2% for TM (P<0.01). Logistic regression analysis revealed that independent risk factors for initial close or positive margins included SSM (odds ratio 2.36, 95% confidence interval [95% CI] 1.05-5.30), multiple ipsilateral tumors (OR 2.12, 95% CI 1.05-4.24), and upper-inner quadrant location (OR 2.58, 95% CI 1.07-6.19). Mean follow-up time was 28months, and the local recurrence rate was 0.9%. Local recurrence rates were not different for those undergoing SSM (1.1%) vs. TM (0.8%, P=NS). Conclusions: Mastectomy patients undergoing SSM, with multiple ipsilateral tumors, and/or upper-inner quadrant disease are at significantly higher risk for inadequate margins of excision. These patients warrant more vigilant intraoperative attention to margin status to ensure adequate margins at the end of the first operation. Society of Surgical Oncology, 2010 Sheikh Fariha Section of Surgical Oncology, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Rebecca Alanna Department of Plastic Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Pockaj Barbara Section of Surgical Oncology, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Wasif Nabil Section of Surgical Oncology, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut McCullough Ann Department of Pathology, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Casey William Department of Plastic Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Kreymerman Peter Department of Plastic Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Gray Richard Section of Surgical Oncology, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 952-956 1068-9265 18:4<952 2011 18 10434 https://doi.org/10.1245/s10434-010-1406-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1406-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sheikh Fariha Section of Surgical Oncology, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Rebecca Alanna Department of Plastic Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Pockaj Barbara Section of Surgical Oncology, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Wasif Nabil Section of Surgical Oncology, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- McCullough Ann Department of Pathology, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Casey William Department of Plastic Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Kreymerman Peter Department of Plastic Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Gray Richard Section of Surgical Oncology, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 952-956 1068-9265 18:4<952 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer