Does Breast Density Increase the Risk of Re-excision for Women with Breast Cancer Having Breast-Conservation Therapy?

Journal Article (Journal Article)

BACKGROUND: Women with dense breasts may have less-accurate preoperative evaluation of extent of disease, potentially affecting the achievement of negative margins. The goal of this study is to examine the association between breast density and re-excision rates in women having breast-conserving surgery for invasive breast cancer. PATIENTS AND METHODS: Women with stage I/II invasive breast cancer treated with breast-conserving surgery between 1/1/2014 and 10/31/2014 were included. Breast density was assessed by two radiologists. The association between breast density and re-excision was examined using logistic regression. RESULTS: Seven hundred and one women were included. Overall, 106 (15.1%) women had at least one re-excision. Younger age at diagnosis was associated with increased breast density (p < 0.001). On univariable analysis, increased breast density was associated with significantly increased odds of re-excision (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.04-1.83), as was multifocal disease, human epidermal growth factor receptor 2 (HER2) positive status, and extensive intraductal component (EIC) (all p < 0.05). On multivariable analysis, breast density remained significantly associated with increased odds of re-excision (OR 1.37, 95% CI 1.00-1.86), as did multifocality and EIC. HER2 positive status was not significantly associated with re-excision on multivariable analysis. CONCLUSIONS: Women with dense breasts are more likely to need additional surgery (re-excision after breast-conserving surgery), but increased breast density did not adversely affect disease-free survival in our study. Our findings support the need for further study in developing techniques that can help decrease re-excisions for women with dense breasts who undergo breast-conserving surgery.

Full Text

Duke Authors

Cited Authors

  • Walsh, SM; Brennan, SB; Zabor, EC; Rosenberger, LH; Stempel, M; Lebron-Zapata, L; Gemignani, ML

Published Date

  • December 2019

Published In

Volume / Issue

  • 26 / 13

Start / End Page

  • 4246 - 4253

PubMed ID

  • 31396783

Pubmed Central ID

  • PMC6868322

Electronic International Standard Serial Number (EISSN)

  • 1534-4681

Digital Object Identifier (DOI)

  • 10.1245/s10434-019-07647-7


  • eng

Conference Location

  • United States