Pathological assessment of the margin status to reduce the recurrence rate in women with DCIS of the breast

Abstract

Introduction: Breast cancer is a major health problem in women worldwide. Many efforts have been done to develop screening strategies and to improve the treatment in order to reduce its incidence, recurrence rate and mortality. Ductal carcinoma in situ is a pre-invasive breast tumor. Despite being more benign than the invasive tumor, it is more difficult to ensure clear margins after the lumpectomy. Over the last years, margin distance has been studied without reaching a consensus. This margin status is the most important prognostic factor in this type of tumor. Objective: The goal of this study is to determine the minimum margins that have to be left in ductal carcinoma in situ undergoing conservative surgery. The objective is to reduce the recurrence rate. The aesthetic result is important too, so it is vital to find the best relation between the recurrence rate and the amount of breast tissue removed. Our aim is to compare the recurrence rate obtained depending on the millimetres left (free from tumor cells) around the tumor. We want the pathologist to take our conclusion distance of the study as a reference to define when a margin is free from tumor cells in the future. Methodology: A longitudinal retrospective and multicenter cohort carried out in the Breast Pathology Unit at eight referral hospitals in Girona. The period of study will be from 2000 to 2017. The sample will be formed by three groups of patients classified by the distance in millimetres of the margins assessment. Participants: Women diagnosed with ductal carcinoma in situ undergoing breast conservative surgery plus radiotherapy between 2000 and 2015. The patients will be selected from the database of the Breast Pathology Unit or the SAP of eight hospitals in Girona