Oncological outcomes related to margin status following skin-sparing mastectomy with immediate implant reconstruction: An 18-year prospective cohort study
In brief
Close margins linked to 10.4% recurrence after mastectomy for invasive cancer, versus 3.8%
In this prospective cohort, patients with invasive breast cancer and involved or close margins had local recurrence in 10.4% of cases, compared with 3.8% among those with clear margins, after about 10 years of follow-up. Radiation was associated with lower recurrence in the involved or close-margin group, but not with clear margins; the nonrandomized findings cannot prove radiation caused the difference.
- Journal
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Q1)
- Published
- 22 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Lucocq J, Seddon I, Wiggins J, Ironside A, MacLennan M, Boland M, et al.
- PMID
- 42925640
- DOI
- 10.1016/j.ejso.2026.112330
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (paper of the day, 26 October 2026): Mastectomy margins, recurrence, and radiotherapy interface
Abstract
BACKGROUND: The relationship between involved/close pathological margins and oncological outcomes following skin-sparing mastectomy (SSM) and implant-based immediate breast reconstruction (IBR) is unclear. METHODS: Consecutive patients undergoing SSM with IBR for invasive breast cancer (IBC) or ductal carcinoma in situ (DCIS) were prospectively studied (2008-2024). The relationship between involved/close margins and recurrence was investigated. RESULTS: 561 patients underwent SSM for IBC (n = 472) or DCIS (n = 89), of whom 174 (31%) had anterior, radial or posterior margins reported as involved (0 mm, n = 37) or close (>0-<1 mm for invasive; >0-<2 mm for DCIS, n = 137). After a median of 124.7 months, 28 patients (5.0%) developed local recurrence (LR) including 27/472 (5.7%) with IBC and 1/89 (1.1%) with DCIS. LR rates were higher in patients with IBC who had involved/close (14/134; 10.4%) versus clear margins (13/338; 3.8%; HR 2.86; 95%CI,1.35-6.10; p = 0.006), regardless of whether IBC (HR 2.77; 95% CI,1.20-6.38; p = 0.017) or DCIS (HR,3.66; 95%CI,1.52-8.84; p = 0.004) was at or close to a margin. LR was significantly higher in IBC patients with close versus clear margins (HR,3.21, 95%CI,1.46-7.03, p = 0.004). PMRT was associated with lower LR in patients with IBC and involved/close margins (PMRT, 2.7% [2/73] versus no PMRT, 19.7% [12/61]; HR,0.14; 95%CI,0.03-0.65; p = 0.011; number needed to treat to prevent one recurrence = 5.9) but not if margins were clear. Four of 28 LR patients died from breast cancer during follow up. CONCLUSIONS: Involved/close margins after SSM were associated with increased local recurrence. PMRT was associated with lower local recurrence in patients with IBC and involved/close margins, but no significant association was observed in patients with clear margins.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.