Abstract P2-12-08: Rates of re-excision surgery after implementation of consensus guidelines on margins for breast- conserving surgery in stage I and II invasive breast cancer: A Nova Scotian experience
Notice bibliographique
Résumé
Abstract Background: In Canada, most women with early invasive breast cancer will be treated with breast-conserving surgery (BCS). The proportion of patients requiring re-excision surgery after BCS varies province to province. Until recently, there was no universally accepted definition for adequate margin width following BCS. The Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) published consensus guidelines in 2014 to help regulate practice. The objective of this study was to determine the proportion of patients undergoing re-excision surgery before and after guideline implementation at our institution. Methods: We performed a retrospective review of all patients with invasive breast cancer and/or ductal carcinoma in situ (DCIS) who underwent re-excision surgery between October 1, 2010- October 31, 2011 (pre-guideline) and October 1, 2014- May 30, 2016 (post-guideline). The proportion of patients requiring re-excision surgery was calculated for each time period and patient characteristics and clinical outcomes were compared. Results: There were 188 patients identified who underwent BCS in the pre-guideline time period and 411 patients in the post-guideline time period. The proportion of patients undergoing re-excision surgery significantly decreased from 13.8 % to 7.8 % after guideline implementation (p = 0.02). Patient characteristics were similar between those who underwent re-excision before and after guideline implementation. In patients requiring re-excision surgery, histological and pathological features were similar between time periods. Margin width and indication for re-excision surgery varied between time periods. Among women who had re-excision surgery in the pre-guideline group, most (50%) had an invasive cancer margin > 1 mm. However, after guideline implementation, a frankly positive invasive cancer margin was the most common indication for re-excision surgery (65%). No significant differences in clinical outcomes were observed between patients who underwent re-excision surgery before and after guideline implementation. Conclusion: The proportion of patients undergoing re-excision surgery after BCS has significantly decreased after SSO-ASTRO guideline implementation at our institution. This data suggests that among women with invasive breast cancer and/or DCIS, the implementation of SSO-ASTRO guidelines has led to a 43.5% decline in re-excision surgery. Citation Format: Drohan AE, Helyer LK. Rates of re-excision surgery after implementation of consensus guidelines on margins for breast- conserving surgery in stage I and II invasive breast cancer: A Nova Scotian experience [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-12-08.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».