Nijveldt, Joni Josja (2024) Outcomes of breast-conserving surgery for breast cancer in the Netherlands. thesis, Medicine.
Full text available on request.Abstract
Introduction Radical removal of all cancer cells in breast-conserving surgery for breast cancer is crucial, as tumor-positive margins require additional therapy. The aim of this thesis is to give insight into the current status of breast-conserving surgery in the Netherlands, besides it aims to identify subgroups with an increased risk of tumor-positive margins and assess the guideline alteration in 2014. Methods All patients undergoing breast-conserving surgery for invasive breast cancer in the Netherlands between 2007 and 2021 were retrospectively reviewed. This thesis used a database from the Integraal Kanker Instituut Nederland (IKNL) with data on patient-, tumor- and operation characteristics. Descriptive statistics and graphs were used and statistical analysis were performed. Results A total of 105.103 patients were included. In 92.186 (89.1%) patients the tumor had a negative margin, 7.150 (6.9%) patients a focally positive margin and 4.105 (4.0%) patients an extensively positive margin. Patients with multifocal disease (OR=2.37; 95%CI 2.25-2.51), neoadjuvant therapy (OR=2.37; 95%CI 2.26-2.50), a lobular histological tumor type (OR=2.89; 95%CI 2.75-3.05) and tumor pT2/3 status (OR=3.10; 95%CI 2.98-3.23) showed most tumorpositive margins. The rate of tumor-positive margins becomes lower and more constant (11,4%- 10,6%) after the guideline alteration in 2014. Discussion A non-radical removal of the tumor in breast-conserving surgery in the Netherlands was found in 10.9 percent of the cases. Most tumor-positive margins were seen in specific subgroups and the guideline alteration had impact on the rate of positive margins. Findings will serve as foundation to future research improving breast cancer treatment for each patient.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dr. Kelder, Wendy |
| Faculty: | Medical Sciences |
| Date Deposited: | 28 Oct 2024 12:51 |
| Last Modified: | 28 Oct 2024 12:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3777 |
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