Factors predicting positive or close surgical margins after Post NACT
Research type
Research Study
Full title
Factors predicting positive or close surgical margins after Post neoadjuvant chemotherapy breast conserving surgery- A retrospective study
IRAS ID
218610
Contact name
B Srinivas Pedamallu
Contact email
Sponsor organisation
Medway NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Neoadjuvant chemotherapy (NACT) is an established primary treatment modality for locally advanced breast carcinoma and also in medium to large tumours (T2 or T3) to facilitate breast conserving surgery. A survival benefit from the neoadjuvant chemotherapy was described as greatest for those who experience pathological complete response. A close (<1mm) or positive surgical margin requires further re-excision surgery or completion mastectomy after breast conserving surgery for adequate oncological control.Our study will aid us to identify factors predicting the need for re-excision after post NACT breast conserving surgery with close(<1mm) or positive surgical margins. This knowledge will help us in surgical planning of these high risk patients to appropriately select breast conserving surgery & mastectomy options for better oncological and cosmetic outcomes.
Objective: To evaluate factors predicting positive or close (<1mm) surgical margins necessitating re-excision after breast conserving surgery in patients who had neoadjuvant chemotherapy.Study Design: Retrospective cohort study
Participants:
• All cases of locally advanced or medium to large breast tumours(T2 or T3), which had neoadjuvant chemotherapy in Medway maritime hospital followed by breast conserving surgery or mastectomy and satisfy the inclusion & exclusion criteria, are included in the study.
Study Interventions and Measures:
• Review of medical records including radiological imaging, histopathology results and clinical letters.
• Primary endpoints: Pathological complete response rates, Breast conserving surgery rates
• Secondary endpoints: Re-excision rates (includes completion mastectomy rates) as a result of close (<1mm) or involved surgical margins after breast conserving surgery.
• Predictive value of factors studied are young age, presence of tumour calcifications, associated DCIS, vascular invasion, presence of axillary lymph node metastasis, surgical specimen weight, post NACT radiological tumour size.REC name
West of Scotland REC 1
REC reference
17/WS/0012
Date of REC Opinion
20 Jan 2017
REC opinion
Favourable Opinion