Difficulty of achieving clear margins in nonpalpable ductal carcinoma of the breast
Menée à partir des données de registres médicaux danois portant sur 4 118 patientes atteintes d'un carcinome canalaire in situ ou d'un cancer invasif non palpable du sein traité entre 2010 et 2013 (âge moyen : 60,9 ans), cette étude évalue, en fonction du type tumoral et du point de vue de la qualité des marges de résection et du taux de réopération, l'efficacité d'un traitement chirurgical conservateur avec fil de guidage
Population-based mammographic screening programs have led to the identification of small nonpalpable breast tumors. More than 20% of tumors detected via such screening are ductal carcinoma in situ (DCIS).1 Breast-conserving surgery is suitable for most tumors detected via such screening. However, if margins are involved, reoperations are required, which could lead to patient distress and increased costs, as well as poor cosmetic outcomes and increased risk of surgical complications. In this issue of JAMA Surgery, Langhans et al2 reviewed information on 4118 patients with nonpalpable tumors (3391 IBC and 727 DCIS) from the Danish National Patient Registry during a 4-year period between January 2010 and December 2013 and demonstrated that the reoperation rate of wire-guided breast-conserving surgery in patients with confirmed invasive breast cancer (IBC) or ductal carcinoma in situ (DCIS) was 3 times higher in patients with DCIS (37.3%) vs those with IBC (13.4%).
JAMA Surgery , commentaire, 2016