Cavity Margins Sample Shaving as Part of Extended Vacuum-Assisted Breast Biopsy: A Potential Approach to Predict Percutaneous Breast Cancer Excision

BACKGROUND: Excision of small breast cancers has been reported by vacuum-assisted biopsy (VAB). Nevertheless, patients are submitted to surgery, because there is no way to predict excision. The purpose of this study was to evaluate extended vacuum-assisted biopsy (EVAB) associated with cavity margins sample shaving (CMSH) to predict breast cancer excision. METHODS: This is a retrospective database analysis of 120 cancers [both invasive breast cancers (IC) and ductal carcinoma in situ (DCIS)] diagnosed by EVAB-CMSH submitted to surgery with histological data from EVAB-CMSH and surgery. The CMSH was evaluated as a diagnostic test for excision compared to surgery as gold standard. Factors associated with residual tumor, gross residual tumor (GRD) (> 3 mm), and false-negative CMSH after EVAB-CMSH were evaluated. RESULTS: A total of 120 cases were analyzed. Media age was 57 (48.5-69); image tumor size (T) was 11 (8.6-15) mm; pathological tumor size (pT) was 6 (4-10) mm; most cases IC+DCIS 53 (44.2%), DCIS 46 (38.3%), and IC 15 (12.5%); 45 (37.5%) were excised by EVAB-CMSH. CMSH sensitivity 70.7%, specificity 66.7%, false-negative rate 18.33%, and accuracy 69.2%. In multivariate analysis, DCIS pT (p = 0.003, odds ratio [OR] 1.46, 95% confidence interval [CI]) was associated with residual tumor; DCIS pT (p = 0.001, OR 1.34, 95% CI) and the CMSH T (p = 0.001, OR 1.67, 95% CI) with GRD; surgical specimen DCIS T (p = 0.015, OR 1.12, 95% CI) with CMSH false negative. CONCLUSIONS: Cavity margins sample shaving is a potential approach to predict small breast cancer excision and should be added to vacuum-assisted excision in prospective trials. For DCIS, EVAB-CMSH should not be standard of care.

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Journal
Annals of Surgical Oncology
Published
2026-08-28
DOI
https://doi.org/10.1245/s10434-026-20464-z
Primary Topic
Breast Cancer Treatment Studies
Type
article
Field-Weighted Citation Impact
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article

Cavity Margins Sample Shaving as Part of Extended Vacuum-Assisted Breast Biopsy: A Potential Approach to Predict Percutaneous Breast Cancer Excision

Felipe Marcondes de Oliveira Coelho, Henrique Lima Couto, Cristina Milene Barbosa Maynart Aragão, Tereza Cristina Ferreira de Oliveira et al.
Annals of Surgical Oncology
Breast Cancer Treatment Studies
article

Cavity Margins Sample Shaving as Part of Extended Vacuum-Assisted Breast Biopsy: A Potential Approach to Predict Percutaneous Breast Cancer Excision

Felipe Marcondes de Oliveira Coelho, Henrique Lima Couto, Cristina Milene Barbosa Maynart Aragão, Tereza Cristina Ferreira de Oliveira, Katyane Larissa Alves, Marcelo Antonini, Ruffo Freitas‐Júnior, Paola Hartung Toppa, Heloísa De Luca Véspoli, Hélio Rubens de Carvalho Nunes, Larissa Barbosa Oliveira, Annamaria Massahud Rodrigues dos Santos, Bernardo Ferreira de Paula Ricardo, André P. L. Mattar, Bruna Torres Silvestre, Aleida Nazareth Soares, Ana Carolina Guglielmelli Mendonça, Shirley das Graças Ferreira, Daniel de Araújo Brito Buttros, Thaís Paiva Moraes, Bertha Andrade Coelho, Eduardo Carvalho Pessoa, R. Saliba, Heverton Leal Ernesto de Amorim, Paula Clarke, Gustavo Machado Badan, Douglas de Miranda Pires, Gabriel de Almeida Silva, Carla Priscila Kamiya Carvalho Pessoa, Letícia Martins de Araújo Campos Linhares, Mayne Cardoso Cani, Amanda Cristina Braga de Oliveira, Marcus Nascimento Borges
article en

Abstract

BACKGROUND: Excision of small breast cancers has been reported by vacuum-assisted biopsy (VAB). Nevertheless, patients are submitted to surgery, because there is no way to predict excision. The purpose of this study was to evaluate extended vacuum-assisted biopsy (EVAB) associated with cavity margins sample shaving (CMSH) to predict breast cancer excision. METHODS: This is a retrospective database analysis of 120 cancers [both invasive breast cancers (IC) and ductal carcinoma in situ (DCIS)] diagnosed by EVAB-CMSH submitted to surgery with histological data from EVAB-CMSH and surgery. The CMSH was evaluated as a diagnostic test for excision compared to surgery as gold standard. Factors associated with residual tumor, gross residual tumor (GRD) (> 3 mm), and false-negative CMSH after EVAB-CMSH were evaluated. RESULTS: A total of 120 cases were analyzed. Media age was 57 (48.5-69); image tumor size (T) was 11 (8.6-15) mm; pathological tumor size (pT) was 6 (4-10) mm; most cases IC+DCIS 53 (44.2%), DCIS 46 (38.3%), and IC 15 (12.5%); 45 (37.5%) were excised by EVAB-CMSH. CMSH sensitivity 70.7%, specificity 66.7%, false-negative rate 18.33%, and accuracy 69.2%. In multivariate analysis, DCIS pT (p = 0.003, odds ratio [OR] 1.46, 95% confidence interval [CI]) was associated with residual tumor; DCIS pT (p = 0.001, OR 1.34, 95% CI) and the CMSH T (p = 0.001, OR 1.67, 95% CI) with GRD; surgical specimen DCIS T (p = 0.015, OR 1.12, 95% CI) with CMSH false negative. CONCLUSIONS: Cavity margins sample shaving is a potential approach to predict small breast cancer excision and should be added to vacuum-assisted excision in prospective trials. For DCIS, EVAB-CMSH should not be standard of care.

Annals of Surgical Oncology
Instituto Federal de Educação, Ciência e Tecnologia de Minas Gerais (BR), Santa Casa Hospital (BR), Centro Universitário de Belo Horizonte (BR), Centro Universitário Claretiano (BR), Hospital do Servidor Público Municipal (BR), Centrus Diagnósticos por Imagem (BR), Red Cross Hospital (GR), Faculdade de Ciências Médicas de Minas Gerais (BR), Universidade de Marília (BR), Grupo Santa Casa de Belo Horizonte (BR), Fleury S.A. (Brazil) (BR), Centro Universitário de João Pessoa (BR), Hospital São Paulo (BR), Mater Dei Hospital (BR), Universidade Estadual de Montes Claros (BR), Universidade Federal de Goiás (BR), Universidade Estadual Paulista (Unesp) (BR)
Eli Lilly and Company, AstraZeneca, Daiichi Sankyo Europe
Good health and well-being
Openalex Percentile: Top 14%
Breast Cancer Treatment Studies
DOIOpen Access PDFOpenAlex
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