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ABSTRACT
Introduction. The inadequate status of the resection margins after breast cancer surgery is an important predictor of local tumor recurrence. The objective of our study was to determine the factors associated with positive or invaded resection margins. Methodology. Our retrospective study included a cohort of 652 patients with early invasive breast cancer who underwent breast cancer conserving surgery at the Val d'Aurelle Regional Cancer Center. We defined positive margins as those with a distance of less than or equal to 2 mm from the tumour. Results. In our study, The median distance from the tumour to the surgical resection site was 5mm [0.0 - 35.0 mm]. Resection margins were positive in 208 patients (31.9%). The rate of positive resection margins was significantly higher in non-menopausal patients ( P =0,0050), , in those with tumours less than 2 cm in size (P = 0,0004), with ductal carcinoma in situ (DCIS) component and without lymph node involvement (P =0,0082) . Re-excision surgery was performed in 229 patients (35.1%). Conclusion. Consideration of each of these factors associated with positive resection margins should help the surgeons to perform a wider excision, in other to obtain clear resection margin during the initial breast cancer surgery.
RÉSUMÉ
Introduction. Le statut inadéquat des berges d’exérèse après chirurgie conservatrice du cancer du sein, représente le facteur prédictif prépondérant de récidives locales. L’objectif de notre étude était de déterminer les facteurs associés à des berges chirurgicales positives ou envahies. Méthodologie. Notre étude rétrospective a porté sur une cohorte de 652 patientes avec cancer invasif du sein au stade précoce, opérées au Centre régional de lutte contre le cancer Val d’Aurelle. Nous avons défini comme berges positives celles dont la distance les séparant de la tumeur était inférieure ou égale à 2 mm. Les données ont été analysées à l’aide du logiciel STATA® 10.0. Résultats. L’âge médian des patientes était de 54 ans [26-85 ans]. 53,7% (350) était ménopausées. La taille tumorale moyenne était de 1,99 cm (+/- 0,95). 66,3% (432) des tumeurs était < 2cm (T1). La distance médiane de la tumeur, à la berge d’exérèse chirurgicale était de 5mm [0,0 – 35,0mm]. 31,9% (208) des berges étaient positives, et 68,1% (444) étaient saines. La proportion de berges positives, était significativement plus élevée chez les patientes non ménopausées, chez celles avec tumeurs de moins de 2 cm, avec composante intracanalaire et sans envahissement ganglionnaire. Conclusion. la considération de chacun des facteurs associés à des berges positives, faciliterait le choix de l’étendue de la résection chirurgicale, limitant ainsi les risques de reprises chirurgicale.

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Véronique Mboua Batoum, Esther Dina Bell, Christianne Jivir Fomu Nsahlai, Metogo Ntsama, J. A. ., Eson Mapoko, B., Marian Gutowski, Simon Thezenas6, & Meka, E. J. (2023). Factors Associated with Borderline or Invaded Margins in Breast Cancer Surgery at the Val d’Aurelle Center for Cancer Research and Control. HEALTH SCIENCES AND DISEASE, 24(2). https://doi.org/10.5281/hsd.v24i2.4201
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