Impact of SSO-ASTRO Margin Guidelines on Re-excision Rate in Breast-conserving Surgery: A Single-center Experience
Article Category: Original Article
Published Online: Jan 23, 2024
Page range: 1 - 12
Received: Jun 19, 2023
Accepted: Aug 22, 2023
DOI: https://doi.org/10.37029/jcas.v10i1.559
Keywords
© 2024 Namra Urooj et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Introduction
Breast-conserving surgery (BCS) has been historically linked with a high rate of re-excision. To address this issue, the Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) developed consensus guidelines in 2014 to standardize practices and improve clinical outcomes for BCS patients. In our tertiary cancer care hospital, we assessed the impact of these guidelines on the re-excision rate following BCS.
Materials and Methods
We conducted a retrospective study on breast cancer patients who underwent BCS at the Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore, Pakistan. The study compared the re-excision rate before the implementation of the SSO-ASTRO consensus guidelines (November 2015–July 2017) and after the implementation (January 2018–August 2019). Margins were considered positive if “ink on tumor” was present and negative if “no ink on tumor” was present. Fisher’s exact test or Chi-square test was used to compare the re-excision rates between the pre- and post-guideline periods.
Results
A total of 919 patients were identified, with 533 from the pre-guideline period and 386 from the post-guideline period. Of the 919 patients, 31 with ductal carcinoma
Conclusion
Implementation of the SSO-ASTRO margin guidelines led to a notable decrease in the overall re-excision rate in our data set. These findings suggest that continued adherence to the guidelines may lead to a further reduction in the re-excision rate in the future.