# Factors Correlated with Post-Surgery Residual Carcinoma in Cases of Breast Cancer Incidentally Found via Vacuum-Assisted Excision: An Ultrasound Perspective

## TL;DR

This study identifies factors linked to leftover cancer after surgery in breast cancer cases found by vacuum-assisted excision, using ultrasound data.

## Contribution

The study introduces ultrasound-based factors that predict residual cancer after surgery in incidentally found breast cancer cases.

## Key findings

- Larger and superficially located carcinomas were more likely to leave residual cancer after surgery.
- Noninvasive, small, and deep carcinomas were fully excised using vacuum-assisted excision.
- VAE pathology and lesion depth were statistically correlated with post-surgery residue.

## Abstract

Objectives: To identify factors correlated with post-surgery residue in cases of breast cancer incidentally found via vacuum-assisted excision (VAE). Methods: A total of 6083 patients were enrolled in a retrospective study. Ultrasound evaluation and ultrasound-guided VAE were performed on these patients. According to the pathology of VAE, 53 patients with incidentally found breast cancer were included in the final analysis. Either breast-conserving surgery or mastectomy was performed. The maximal diameter, depth, location, BIRADS category, and Adler’s grade of all lesions before VAE was reviewed and recorded. VAE and post-surgery pathologies were used as gold standards. Either Pearson’s chi-square test or Fisher’s exact test was used for comparison of categorical variables. Results: The mean age of the enrolled patients was 49 years (IQR: 43–55 years). The mean maximal diameter of the lesions was 11.3 mm (IQR: 7–15 mm). There were twenty-eight ductal carcinomas in situ, twelve invasive ductal carcinomas, five lobular carcinomas in situ, two invasive lobular carcinomas, four intraductal papillary carcinomas, and two mucinous carcinomas. Post-surgery pathology showed 15 cases with residual cancer and 38 cases with no residual cancer. The maximal diameter, depth, and pathology derived via VAE were statistically correlated with post-surgery residue (p < 0.05). Conclusions: Small incidentally found noninvasive carcinomas located comparatively deep in the breast could be totally excised by ultrasound-guided vacuum-assisted excision. Both large and superficially invasive carcinomas were more likely to be associated with residue.