Sara Grendele,Alice Pellegrini,Marica Melina,Andrea Lippi,Margherita Serra,Mario Taffurelli,Simone Zanotti,
The Role of Margin Status on Local Recurrence in Microinvasive Ductal  Carcinoma of the Breast
Surgical Case Reports
2021
2613-5965
http://dx.doi.org/10.31487/j.SCR.2021.07.06
https://www.sciencerepository.org/the-role-of-margin-status-on-local-recurrence_SCR-2021-7-106 
Abstract: Microinvasive ductal carcinoma (MIDC) is an infrequent disease that accounts for about 1% of all breast 
cancer cases. Controversy on the management is related to the limited information available regarding 
lymph node involvement, recurrence rate and prognosis of the disease. In this retrospective single-center 
study, we included all patients diagnosed with MIDC at S. Orsola Malpighi Hospital in Bologna from 2011 
to 2020. Demographic and clinicopathologic characteristics were collected and analysed. Furthermore, we 
analysed the factors related to local recurrence using univariate and multivariate analyses. We identified 57 
patients diagnosed with MIDC. The median age at diagnosis was 56. Nuclear grade of the invasive foci was 
high in 44% of the patients. Estrogen receptors were found to be positive in 40% of patients, HER2 was 
overexpressed in 35% and 40% of patients had a high proliferation rate. Margin status was negative in 72% 
of the patients while close in 16 patients. 26 patients received breast conserving surgery (BCS) and 31 
underwent mastectomy. Nodal staging with sentinel lymph node biopsy was performed in 82% of cases. In 
96% were found negative sentinel lymph node. 92% of patients receiving BCS were treated with combined 
radiotherapy. 32% were treated with adjuvant endocrine therapy and 28% were given adjuvant 
chemotherapy. At a median follow-up of 42 months, we had no axillary recurrence, but 3 patients (5%) had 
local recurrence. In the multivariate analysis close margins are associated with a 16% increase in local 
recurrence. Results from this study show that sentinel lymph node biopsy could not be useful in MIDC 
according to the low risk of lymph node metastasis. The rate of local recurrence was 5% and our findings 
suggested a possible role of margin status in the development of local recurrence.
Keywords: Breast cancer, microinvasive ductal carcinoma, margin status, local recurrence, breast surgery