caa a22 4500 445339055 CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1918-6 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1918-6 Margin Index Is Not a Reliable Tool for Predicting Residual Disease after Breast-Conserving Surgery for DCIS [Elektronische Daten] [Carla Fisher, V. Klimberg, Seema Khan, Feng Gao, Julie Margenthaler] Objective: We previously introduced the concept of margin index as a method for prediction of residual disease after attempted breast-conserving therapy (BCT). We sought to apply the margin index to patients with ductal carcinoma in situ (DCIS) to determine its reliability in predicting residual disease. Methods: We identified all patients with DCIS who were treated with BCT from 2004 to 2010. Margin index was calculated as follows: margin index=closest margin (mm)/tumor size (mm)×100. A receiver operating curve was created using the derived margin index and the presence or absence of residual disease in the re-excision specimen. Sensitivity and specificity were calculated at various margin indices to identify the optimum margin index. Results: Of 380 patients undergoing attempted BCT, 109 (29%) underwent re-excision. Of 109 patients undergoing re-excision, 46 (42%) had positive margins and were excluded from the study, 15 (14%) were excluded due to inability to determine the size of DCIS on pathology reports, and 48 (44%) met study criteria and were included in the analysis. Of 48 patients undergoing re-excision, 19 (40%) had residual disease. The receiver operating curve c index was 0.65. However, there was no optimum margin index that reliably predicted the presence or absence of residual disease. Conclusions: Margin index is not a reliable method for prediction of residual disease after attempted BCT with close margins in patients with DCIS only. This may be a reflection of the complexities in accurately determining DCIS size and margin status in pathologic specimens. Society of Surgical Oncology, 2011 Fisher Carla Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA aut Klimberg V. Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA aut Khan Seema Department of Surgery, Northwestern University School of Medicine, Chicago, IL, USA aut Gao Feng Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA aut Margenthaler Julie Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA aut Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3155-3159 1068-9265 18:11<3155 2011 18 10434 https://doi.org/10.1245/s10434-011-1918-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1918-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fisher Carla Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Klimberg V. Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Khan Seema Department of Surgery, Northwestern University School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 700 1- Gao Feng Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Margenthaler Julie Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3155-3159 1068-9265 18:11<3155 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer