Indication for relumpectomy--a useful scoring system in cases of invasive breast cancer.

Background and Objectives: In two-thirds of breast cancer patients undergoing reoperation no residual tumor will be found. A scoring system for selection of patients who might benefit from relumpectomy is proposed. Methods: This study is based on 293 patients with invasive breast cancer undergoing reoperation due to margins of < 2 mm. Eighteen parameters were evaluated by univariate and multivariate stepwise logistic regression. Results: Univariate analysis identified nine parameters associated with a residual invasive tumor: surgical margins; lobular histological type; grade 3; multifocality; positive lymph modes; non-fine needle localization (FNL) versus FNL lumpectomy; vascular/lymphatic invasion; age < 50 years; and tumor size >= 3 cm. Multivariate stepwise logistic regression study identified six out of nine parameters associated with a higher probability of finding a residual invasive tumor: margins < 1 mm, multifocality, tumor size >= 3 cm, positive lymph nodes, age < 50 years, and lumpectomy without previous FNL. Odds of these factors were used for scoring. Conclusions: For patients with surgical margins < 2 mm and a score of < 4, the probability of finding a residual invasive tumor is 0%, while the probability of finding a microfocus of < 2 mm of invasive carcinoma is 3.2% and of finding residual DCIS is up to 10%. J. Surg. Oncol. 2012; 105: 376-380. (C) 2011 Wiley Periodicals, Inc.