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Prior reports grossly underestimate the risk of margin positivity with IBC containing a DCIS component (IBC\u2009+\u2009DCIS) due to patient-level rather than margin-level analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>The aim of this study was to delineate the relative risk of IBC\u2009+\u2009DCIS compared with pure IBC (without a DCIS component) on margin positivity through detailed margin-level interrogation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A single institution, retrospective, observational cohort study was conducted in which pathology databases were evaluated to identify patients who underwent BCS over 5\u00a0years (2014\u20132019). Margin-level interrogation included granular detail into the extent, pathological subtype and grade of disease at each resection margin. Predictors of a positive margin were computed using multivariate regression analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Clinicopathological details were examined from 5454 margins from 909 women. The relative risk of a positive margin with IBC\u2009+\u2009DCIS versus pure IBC was 8.76 (95% confidence interval [CI] 6.64\u201311.56) applying UK Association of Breast Surgery guidelines, and 8.44 (95% CI 6.57\u201310.84) applying the Society of Surgical Oncology\/American Society for Radiation Oncology guidelines. Independent predictors of margin positivity included younger patient age (0.033, 95% CI 0.006\u20130.060), lower specimen weight (0.045, 95% CI 0.020\u20130.069), multifocality (0.256, 95% CI 0.137\u20130.376), lymphovascular invasion (0.138, 95% CI 0.068\u20130.208) and comedonecrosis (0.113, 95% CI 0.040\u20130.185).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Compared with pure IBC, the relative risk of a positive margin with IBC\u2009+\u2009DCIS is approximately ninefold, significantly higher than prior estimates. This margin-level methodology is believed to represent the impact of DCIS more accurately on margin positivity in IBC.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1245\/s10434-024-15153-8","type":"journal-article","created":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T13:01:52Z","timestamp":1711198912000},"page":"3939-3947","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Clinicopathological Predictors of Positive Resection Margins in Breast-Conserving Surgery"],"prefix":"10.1245","volume":"31","author":[{"given":"Hemali","family":"Chauhan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Jiwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikneswaran Raj","family":"Nagarajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Thiruchelvam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Hogben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ragheed","family":"Al-Mufti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri","family":"Hadjiminas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Shousha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramsey","family":"Cutress","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hutan","family":"Ashrafian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoltan","family":"Takats","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Richard","family":"Leff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,23]]},"reference":[{"key":"15153_CR1","unstructured":"National Cancer Registration and Analysis Service PHE. 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Hutan Ashrafian is the Chief Scientific Officer for Preemptive Health and Medicine, Flagship Pioneering. Hemali Chauhan, Natasha Jiwa, Vikneswaran Raj Nagarajan, Paul Thiruchelvam, Katy Hogben, Ragheed Al-Mufti, Dimitri Hadjiminas, Sami Shousha, Zoltan Takats, and Daniel Richard Leff have no conflict of interest to declare in relation to this study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"DISCLOSURE"}}]}}