The influence of biological characteristics of breast cancer on the extent of breast conserving surgery

ZHAO Kaihua; TAN Zhengshuai; FANG Kun; LI Peiying; LI Zhenfeng; GONG Lei; LIU Songling; WANG Binggao; YAN Zheng

doi:10.3969/j.issn.1009-0460.2019.01.014

Abstract：Objective To investigate the relationship between the biological characteristics of breast cancer and the extent of breast conserving surgery. Methods Three hundred and three patients with stage I-II palpable masses and non-special breast cancer were divided into Luminal A group, Luminal B group, Luminal-HER-2 group, HER-2 overexpression group and triple negative breast cancer group according to molecular classification. Mammography images were characterized by mass, calcification, structural distortion, asymmetrical density and spicule sign with BI-RADS classification standard. Preoperative molybdenum target labeling was used to determine the extent of the lesion, the initial state of the incision margin was determined by intraoperative rapid pathology, and paraffin pathology was used to confirm the state of the incision margin and the classification of the tumors. The factors affecting the extent of breast conserving surgery were analyzed in combination with molybdenum target imaging signs and types of signs. Results Thirty-three patients had positive margin of incision. The molecular subtypes of breast cancer were positively correlated with the growth pattern in molybdenum target images (P ＜ 0. 001). The incision margin of breast conserving surgery was not related to molybdenum target image, marginal burr sign and molecular typing (P＞ 0. 05), but to the growth pattern in molybdenum target images and marginal calcification sign (P ＜ 0. 05). Conclusion For non-special breast cancer patients, mammography features (growth pattern, margin signs) and molecular subtypes can be combined to determine the individual resection range in order to reduce the probability of re-excision.