Studying the resection margins during organ-sparing operations and oncoplastic resections in patients with breast cancer

DOI: https://doi.org/10.29296/25877305-2023-05-12
Issue: 
5
Year: 
2023

F. Khugaeva(2); A. Zikiryakhodzhaev(1–3), MD; E. Rasskazova(1), Candidate of Medical Sciences; N. Volchenko(1), MD; Professor I. Reshetov(1, 2), MD, Academician of the Russian Academy of Sciences
1-P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia
2-I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
3-Peoples’ Friendship University of Russia, Moscow, Russia

Breast cancer (BC) comes to the forefront among the malignant neoplasms in the prevalence in women. The treatment of BC is complex; however, the surgical stage is the main one. Today, there are a lot of publications describing the characteristics of organ-sparing operations (OSOs) and oncoplastic resections (OPRs); however, There is no detailed description of the marking of resection margins. The development of the unified standard for morphopathological evaluation of surgical material and its analysis and will ultimately result in the clearer identification of a relationship between the resection margins and local recurrences, will eventually decline the number of reoperations. The authors give the results of their own investigation studying the resection margins in patients with BC (n=350) after OSOs and OPRs.
Keywords: 
oncology
breast cancer
organ-sparing operations
oncoplastic resections
radiation therapy
resection margins
positive margins of resection R1
recurrent breast cancer
intraoperative evaluation of the margins
positive margins
re-resection

References: 
  1. Каприн А.Д., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2017 г. (заболеваемость и смертность). М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России, 2018, 2020 [Kaprin A.D., Starinskii V.V., Petrova G.V. Zlokachestvennye novoobrazovaniya v Rossii v 2017 g. (zabolevaemost' i smertnost'). M.: MNIOI im. P.A. Gertsena – filial FGBU «NMIRTs» Minzdrava Rossii, 2018, 2020 (in Russ.)].
  2. Волченко Н.Н., Борисова О.В., Мельникова В.Ю. и др. Срочная морфологическая диагностика в онкологии. Онкология. Журнал им. П.А. Герцена. 2020; 9 (1): 5–13 [Volchenko N.N., Borisova O.V., Melnikova V.Yu. et al. Urgent morphological diagnosis in oncology. P.A. Herzen Journal of Oncology. 2020; 9 (1): 5–13 (in Russ.)]. DOI: /10.17116/onkolog202090115
  3. Зикиряходжаев А.Д., Волченко Н.Н., Решетов И.В. и др. Новые методики определения краев резекций при органосохраняющих операциях у больных раком молочной железы. Акушерство и гинекология. 2020; 6: 132–40 [Zikiryakhodzhaev A.D., Volchenko N.N., Reshetov I.V. et al. New procedures for determining resection margins during organ-sparing surgery in patients with breast cancer. Obstetrics and Gynecology. 2020; 6: 132–40 (in Russ.)]. DOI: 10.18565/aig.2020.6.132-140
  4. Kuritzky A., Reyna C., McGuire K.P. et al. Evaluation of 2014 margin guidelines on re-excision and recurrence rates after breast conserving surgery: A multi-institution retrospective study. Breast. 2020; 51: 29–33. DOI: 10.1016/j.breast.2020.02.013
  5. Iqbal J., Ginsburg O., Rochon P.A. et al. Differences in breast cancer stage at diagnosis and cancer-specific survival by race and ethnicity in the United States. JAMA. 2015; 313 (2): 165–73. DOI: 10.1001/jama.2014.17322
  6. Luini A., Rososchansky J., Gatti G. et al. The surgical margin status after breast-conserving surgery: discussion of an open issue. Breast Cancer Res Treat. 2009; 113 (2): 397–402. DOI: 10.1007/s10549-008-9929-0
  7. Balic M., Thomssen C., Würstlein R. et al. St. Gallen/Vienna 2019: A brief summary of the consensus discussion on the optimal primary breast cancer treatment. Breast Care. 2019; 14 (2): 103–10. DOI: 10.1159/000499931
  8. Pradipta A.R., Tanei T., Morimoto K. et al. Emerging Technologies for Real-Time Intraoperative Margin Assessment in Future Breast-Conserving Surgery. Adv Sci. 2020; 7 (9): 1901519. DOI: 10.1002/advs.201901519
  9. Mariscotti G., Durando M., Pavan L.J. et al. Intraoperative breast specimen assessment in breast conserving surgery: Comparison between standard mammography imaging and a remote radiological system. Br J Radiol. 2020; 1109 (93): 20190785. DOI: 10.1259/bjr.20190785
  10. Максимов Н.А., Арсланов Х.С., Шивилов Е.В. и др. Методика оценки краев резекции при органосохранных операциях у пациенток с микрокальцинатами молочной железы. Радиология – практика. 2020; 6: 6–15 [Maksimov N.A., Arslanov H.S., Shivilov E.V. et al. Margins Evaluation Method During Breast-Conserving Surgery in Рatients with Microcalcification. Radiology – Practice. 2020; 6: 6–15 (in Russ.)].
  11. Tang S.S.K., Kaptanis S., Haddow J.B. et al. Current margin practice and effect on re-excision rates following the publication of the SSO-ASTRO consensus and ABS consensus guidelines: a national prospective study of 2858 women undergoing breast-conserving therapy in the UK and Ireland. Eur J Cancer. 2017; 84: 315–24. DOI: 10.1016/j.ejca.2017.07.032
  12. Rana M.K. et al. Evolution of Frozen Section in Carcinoma Breast: Systematic Review. Int J Breast Cancer. 2022; 2022: 4958580. DOI: 10.1155/2022/4958580
  13. Miller C.L., Coopey S.B., Rafferty E. et al. Comparison of intra-operative specimen mammography to standard specimen mammography for excision of non-palpable breast lesions: a randomized trial. Breast Cancer Res Treat. 2016; 155 (3): 513–9. DOI: 10.1007/s10549-016-3700-8
  14. Летягин В.П. и др. Современные стандарты лечения больных первичным раком молочной железы. Мат-лы Междунар. конф. «Рак молочной железы» 22–24 января 2014 г. М., 2014 [Letyagin V.P. et al. Sovremennye standarty lecheniya bol'nykh pervichnym rakom molochnoi zhelezy. Mat-ly Mezhdunar. konf. « Rak molochnoi zhelezy » 22–24 yanvarya 2014 g. M., 2014 (in Russ.)].