Does breast density increase the risk of re-excision for women with breast cancer having breast-conservation therapy?

Women with dense breasts may have less accurate pre-operative imaging estimation of tumour size. This may in turn affect the margin re-excision rates in women receiving breast conserving surgery (BCS). This study examined the association between breast density (using the BIRADS classification) and re-excision rates in 701 patients with invasive breast cancer. 15.1% of women had at least one re-excision. Younger age was associated with increased breast density (p<0.001). Median tumour size was 1.2cm (range 0.1-4.5cm) with multifocal disease present in 19.8%. MRI was performed in 14.7% of patients, and more frequently utilised in women with denser breasts (27.6% vs. 9%; p<0.001). Extensive Intraductal Component (EIC) was seen in 7.4%. On multivariate analysis, breast density was significantly associated with increased odds of re-excision (OR 1.37; p=0.049), as did multifocality (p<0.001) and the presence of EIC. The study findings support the need for developing techniques that can reduce re-excision rates for women with dense breasts who undergo BCS

Classifications: Breast & Oncoplastic Surgery

Keywords: Breast Conserving Surgery Surgical Margins