Indication for relumpectomya useful scoring system in cases of invasive breast cancer

Background and Objectives In two-thirds of breast cancer patients undergoing reoperation no residual tumor will be found. A scoring system for selection of patients who might benefit from relumpectomy is proposed. Methods This study is based on 293 patients with invasive breast cancer undergoing reoperation due to margins of <2mm. Eighteen parameters were evaluated by univariate and multivariate stepwise logistic regression. Results Univariate analysis identified nine parameters associated with a residual invasive tumor: surgical margins; lobular histological type; grade 3; multifocality; positive lymph modes; non-fine needle localization (FNL) versus FNL lumpectomy; vascular/lymphatic invasion; age <50 years; and tumor size ≤yen;3cm. Multivariate stepwise logistic regression study identified six out of nine parameters associated with a higher probability of finding a residual invasive tumor: margins <1mm, multifocality, tumor size ≤yen;3cm, positive lymph nodes, age <50 years, and lumpectomy without previous FNL. Odds of these factors were used for scoring. Conclusions For patients with surgical margins <2mm and a score of <4, the probability of finding a residual invasive tumor is 0%, while the probability of finding a microfocus of <2mm of invasive carcinoma is 3.2% and of finding residual DCIS is up to 10%.