Halevy et al developed a score for identify a woman with invasive breast cancer who may need to have additional surgery after lumpectomy. The authors are from Tel Aviv University.
Patient selection: invasive breast carcinoma treated with lumpectomy, with margin less than 2 mm from edge of tumor
Parameters:
(1) age of the patient
(2) distance to surgical margin
(3) size of tumor
(4) type of lumpectomy (with or without fine needle localization or FNL)
(5) multifocality
(6) lymph node status
Parameter
Finding
Points
age of the patient
< 50 years
2
>= 50 years
0
distance to surgical margin
< 1 mm (including positive)
2.5
1 to 1.99 mm
0
size of the tumor
< 3 cm
0
>= 3 cm
3
type of lumpectomy
with FNL
0
without FNL
3.5
multifocality of tumor
no
0
yes
8.5
lymph node status
negative
0
positive
2
score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21.5
• The higher the score the more likely that significant disease will be found on re-excision.
Score and Findings After Relumpectomy
Invasive Carcinoma >= 2 mm
Invasive Carcinoma < 2 mm (Microscopic)
DCIS
0 to 3.9
0%
3.5%
7%
4 to 7.9
3%
15%
15%
8 to 11.9
16%
13%
11%
12 to 15.9
50%
0%
13%
16 to 21.5
100%
0%
0%
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