Cavity Margins Sample Shaving as Part of Extended Vacuum-Assisted Breast Biopsy: A Potential Approach to Predict Percutaneous Breast Cancer Excision.
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Clarke Paula, Pessoa Eduardo Carvalho, Coelho Bertha Andrade, de Araújo Brito Buttros Daniel, Soares Aleida Nazareth, da Silva Bruna Torres Silvestre, de Carvalho Nunes Hélio Rubens, Pessoa Carla Priscila Kamiya Carvalho, de Oliveira Amanda Cristina Braga, de Oliveira Ferreira Tereza Cristina, de Paula Ricardo Bernardo Ferreira, Toppa Paola Hartung, Mattar André, Antonini Marcelo, de Amorim Heverton Leal Ernesto, Badan Gustavo Machado, de Freitas Júnior Ruffo, Borges Marcus Nascimento, Alves Katyane Larissa, de Miranda Pires Douglas, das Graças Ferreira Shirley, de Almeida Silva Júnior Gabriel, Saliba Romana Giordani Ribeiro, Mendonça Ana Carolina Guglielmelli, Oliveira Larissa Barbosa, Moraes Thais Paiva, Aragão Cristina Milene Barbosa Maynart, de Oliveira Coelho Felipe Marcondes, de Araújo Campos Linhares Letícia Martins, De Luca Vespoli Heloisa Maria, Dos Santos Annamaria Massahud Rodrigues, Cani Mayne Cardoso, Couto Henrique Lima
Аннотация
METHODS: This is a retrospective database analysis of 120 cancers [both invasive breast cancers (IC) and ductal carcinoma in situ (DCIS)] diagnosed by EVAB-CMSH submitted to surgery with histological data from EVAB-CMSH and surgery. The CMSH was evaluated as a diagnostic test for excision compared to surgery as gold standard. Factors associated with residual tumor, gross residual tumor (GRD) (> 3 mm), and false-negative CMSH after EVAB-CMSH were evaluated.
RESULTS: A total of 120 cases were analyzed. Media age was 57 (48.5-69); image tumor size (T) was 11 (8.6-15) mm; pathological tumor size (pT) was 6 (4-10) mm; most cases IC+DCIS 53 (44.2%), DCIS 46 (38.3%), and IC 15 (12.5%); 45 (37.5%) were excised by EVAB-CMSH. CMSH sensitivity 70.7%, specificity 66.7%, false-negative rate 18.33%, and accuracy 69.2%. In multivariate analysis, DCIS pT (p = 0.003, odds ratio [OR] 1.46, 95% confidence interval [CI]) was associated with residual tumor; DCIS pT (p = 0.001, OR 1.34, 95% CI) and the CMSH T (p = 0.001, OR 1.67, 95% CI) with GRD; surgical specimen DCIS T (p = 0.015, OR 1.12, 95% CI) with CMSH false negative.
CONCLUSIONS: Cavity margins sample shaving is a potential approach to predict small breast cancer excision and should be added to vacuum-assisted excision in prospective trials. For DCIS, EVAB-CMSH should not be standard of care.