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<p>Re-operation following breast-conserving surgery (BCS) for breast cancer remains a challenge, with implications for patient outcomes and healthcare resources. Identifying predictors of re-operation can aid preoperative planning and reduce the likelihood of additional procedures. A retrospective cohort study was conducted on 285 patients who underwent BCS at York Hospital between January 1st and December 31st, 2023. Participants were identified from a prospectively maintained database. Variables analysed included age, body mass index (BMI), menopausal status, hormone replacement therapy (HRT) use, core biopsy features of in situ disease, calcification, comedonecrosis, cancer type, pre- and postoperative size discordance (≥ 5&#xa0;mm), and whether preoperative localisation was performed. Statistical significance was assessed using multivariate logistic regression. Re-operation was performed in 50 of 285 cases (17.5%). The mean age was 60.7 years. Of the cases, 246 (86.3%) were invasive cancers and 39 (21%) were ductal carcinoma in situ (DCIS). In situ disease was present on core biopsy in 127 cases (45%), and 112 (39.3%) showed ≥ 5&#xa0;mm size discordance between imaging and histology. Among those re-operated, 29 (58%) had in situ disease and 38 (76%) had size discordance. In situ disease increased re-excision risk 2.27-fold (<i>p</i> = 0.036), while size discordance ≥ 5&#xa0;mm increased the risk 6.94-fold (<i>p</i> &lt; 0.001). Other factors were not statistically significant. In situ disease on core biopsy and ≥ 5&#xa0;mm imaging-histology size discordance significantly predict re-excision in BCS. These findings support preoperative consideration of MRI or contrast-enhanced mammography to aid appropriate surgical planning for high-risk patients.</p>

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Predictors of Re-excision in Breast-conserving Surgery for Breast Cancer

  • 期刊论文

  • 发表日期：

    2026年3月14日

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  • Yasaman Salari,
  • Jenny Piper,
  • Isabelle Hanson,
  • Bhavani Rengabashyam

摘要

Re-operation following breast-conserving surgery (BCS) for breast cancer remains a challenge, with implications for patient outcomes and healthcare resources. Identifying predictors of re-operation can aid preoperative planning and reduce the likelihood of additional procedures. A retrospective cohort study was conducted on 285 patients who underwent BCS at York Hospital between January 1st and December 31st, 2023. Participants were identified from a prospectively maintained database. Variables analysed included age, body mass index (BMI), menopausal status, hormone replacement therapy (HRT) use, core biopsy features of in situ disease, calcification, comedonecrosis, cancer type, pre- and postoperative size discordance (≥ 5 mm), and whether preoperative localisation was performed. Statistical significance was assessed using multivariate logistic regression. Re-operation was performed in 50 of 285 cases (17.5%). The mean age was 60.7 years. Of the cases, 246 (86.3%) were invasive cancers and 39 (21%) were ductal carcinoma in situ (DCIS). In situ disease was present on core biopsy in 127 cases (45%), and 112 (39.3%) showed ≥ 5 mm size discordance between imaging and histology. Among those re-operated, 29 (58%) had in situ disease and 38 (76%) had size discordance. In situ disease increased re-excision risk 2.27-fold (p = 0.036), while size discordance ≥ 5 mm increased the risk 6.94-fold (p < 0.001). Other factors were not statistically significant. In situ disease on core biopsy and ≥ 5 mm imaging-histology size discordance significantly predict re-excision in BCS. These findings support preoperative consideration of MRI or contrast-enhanced mammography to aid appropriate surgical planning for high-risk patients.