Liu P, Zhao Y, Rong DD, Li KF, Wang YJ, Zhao J, Kang H. Diagnostic value of preoperative examination for evaluating margin status in breast cancer. World J Clin Cases 2023; 11(20): 4852-4864 [PMID: 37583993 DOI: 10.12998/wjcc.v11.i20.4852]
Corresponding Author of This Article
Hua Kang, MD, Chief Doctor, Department of General Surgery, Center for Thyroid and Breast Surgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. kanghua@xwh.ccmu.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 16, 2023; 11(20): 4852-4864 Published online Jul 16, 2023. doi: 10.12998/wjcc.v11.i20.4852
Diagnostic value of preoperative examination for evaluating margin status in breast cancer
Peng Liu, Ye Zhao, Dong-Dong Rong, Kai-Fu Li, Ya-Jun Wang, Jing Zhao, Hua Kang
Peng Liu, Ye Zhao, Kai-Fu Li, Ya-Jun Wang, Jing Zhao, Hua Kang, Department of General Surgery, Center for Thyroid and Breast Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Peng Liu, Department of General Surgery, Beijing Fengtai Hospital, Beijing 100071, China
Dong-Dong Rong, Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Author contributions: Liu P and Kang H designed the study; Liu P, Zhao Y, and Rong DD wrote the manuscript; Liu P, Li KF, and Zhao J performed the experiments; Zhao Y, Rong DD and Wang YJ analyzed the data; Hua Kang reviewed and revised the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Xuanwu Hospital, Capital Medical University.
Informed consent statement: The data used in this study were not related to the patients’ privacy information, so the informed consent was waived by the Ethics Committee of Xuanwu Hospital, Capital Medical University. All data obtained, recorded, and managed were only used for this study, without any harm to the patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hua Kang, MD, Chief Doctor, Department of General Surgery, Center for Thyroid and Breast Surgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. kanghua@xwh.ccmu.edu.cn
Received: May 11, 2023 Peer-review started: May 11, 2023 First decision: May 31, 2023 Revised: June 8, 2023 Accepted: June 21, 2023 Article in press: June 21, 2023 Published online: July 16, 2023 Processing time: 62 Days and 6.8 Hours
ARTICLE HIGHLIGHTS
Research background
Breast cancer is a prevalent malignancy among women, and surgical treatment remains a widely employed approach. However, the presence of positive margins following surgery frequently results in cancer recurrence and metastasis, significantly impacting the treatment outcome and patient prognosis.
Research motivation
With the continuous improvement of medical technology, the treatment of breast cancer is becoming increasingly comprehensive, yet positive margins leading to recurrence and metastasis remain important factors affecting the treatment effect and patient prognosis.
Research objectives
This study aims to investigate the diagnostic value of various preoperative examination methods for breast cancer margin status.
Research methods
A retrospective study was conducted on 323 breast cancer patients who met the criteria for undergoing breast-conserving surgery (BCS). Data on preoperative imaging, as well as intraoperative and postoperative pathological findings, were collected. The patients were categorized into groups based on the presence of positive or negative margins. The data were randomly split into a training set and a validation set. Non-conditional logistic regression and LASSO regression were applied to the validation set to identify risk factors associated with the failure of BCS.
Research results
The presence of non-mass enhancement on magnetic resonance imaging (MRI), indistinct margins on ultrasound and molybdenum target examination, as well as tumor size larger than 2 cm, were identified as factors that elevate the risk of positive margins.
Research conclusions
The model utilizes preoperative evaluation results from ultrasound, molybdenum target, MRI, and core needle biopsy pathology, all of which were aligned with the actual situation. This provides reliable guidance for clinical decision-making concerning BCS.
Research perspectives
This study established a computational model to forecast the success of BCS using variables such as ER-positive status, mammography tumor type, maximum intensity projection imaging feature, and MRI tumor type. This has significant implications for preoperative evaluation and the selection of appropriate surgical interventions, thus improving surgical success rates and negative margin rates.
