Abstract：
OBJECTIVE: Patients with invasive lobular carcinoma (ILC) face high rates of positive margins and completion mastectomy, which can be improved with the use of specific techniques, such as oncoplastic surgery. However, prior studies have shown that type of breast cancer surgery performed is also associated with patient factors such as elevated body mass index (BMI). Thus, this study investigates whether BMI impacts the type of surgical interventions in patients with ILC.
METHODS: A retrospective analysis of 705 patients with stage I-III ILC from an institutional database was conducted. Patients were stratified by BMI (underweight, normal weight, overweight, obese). Pearson\'s Chi-square, ANOVA, and multivariable logistic regression were used to evaluate the relationship between BMI and surgical procedures.
RESULTS: Breast-conserving surgery (BCS) was the initial operation in 60% of patients, with no significant difference by BMI. Among those undergoing BCS, patients with obese BMI were significantly more likely to undergo oncoplastic surgery (46.9% vs. 7.7%, 37.3%, and 33.6% for underweight, normal, and overweight, respectively, p = 0.032). Obese BMI patients undergoing mastectomy were less likely to have reconstruction compared to those with underweight, normal weight, and overweight BMI (44.2% vs. 50%, 71.1%, and 64.1%, p = 0.002).
CONCLUSIONS: Overweight/obese BMI patients with ILC underwent different surgical interventions compared to those with lower BMI. While initial BCS rates were similar, overweight/obese patients had higher oncoplastic surgery rates in BCS and lower reconstruction rates in mastectomy. Further research is needed to understand BMI\'s impact on surgical decisions and outcomes in ILC.
METHODS: A retrospective analysis of 705 patients with stage I-III ILC from an institutional database was conducted. Patients were stratified by BMI (underweight, normal weight, overweight, obese). Pearson\'s Chi-square, ANOVA, and multivariable logistic regression were used to evaluate the relationship between BMI and surgical procedures.
RESULTS: Breast-conserving surgery (BCS) was the initial operation in 60% of patients, with no significant difference by BMI. Among those undergoing BCS, patients with obese BMI were significantly more likely to undergo oncoplastic surgery (46.9% vs. 7.7%, 37.3%, and 33.6% for underweight, normal, and overweight, respectively, p = 0.032). Obese BMI patients undergoing mastectomy were less likely to have reconstruction compared to those with underweight, normal weight, and overweight BMI (44.2% vs. 50%, 71.1%, and 64.1%, p = 0.002).
CONCLUSIONS: Overweight/obese BMI patients with ILC underwent different surgical interventions compared to those with lower BMI. While initial BCS rates were similar, overweight/obese patients had higher oncoplastic surgery rates in BCS and lower reconstruction rates in mastectomy. Further research is needed to understand BMI\'s impact on surgical decisions and outcomes in ILC.
摘要：
目的：浸润性小叶癌（ILC）患者切缘和完成乳房切除术的阳性率很高，可以通过使用特定的技术来改进，比如肿瘤整形手术。然而,先前的研究表明，进行的乳腺癌手术类型也与患者因素有关，例如体重指数（BMI）升高。因此，本研究调查BMI是否影响ILC患者的手术干预类型.
方法：对来自机构数据库的705例I-III期ILC患者进行回顾性分析。患者按BMI分层(体重不足，正常体重,超重,肥胖)。皮尔森卡方，方差分析,采用多变量logistic回归分析BMI与手术方式的关系。
结果：保乳手术（BCS）是60%患者的初始手术，BMI无显著差异。在那些接受BCS的人中，BMI肥胖的患者接受肿瘤整形手术的可能性更高(46.9%vs.7.7%,37.3%,体重过轻的占33.6%，正常,超重，分别,p=0.032)。与体重不足的患者相比，肥胖的BMI患者接受乳房切除术的可能性较小。正常体重,和超重的BMI(44.2%vs.50%,71.1%,和64.1%，p=0.002)。
结论：与BMI较低的患者相比，超重/肥胖的ILC患者接受了不同的手术干预。虽然最初的BCS率相似，超重/肥胖患者在BCS中的肿瘤再生手术率较高,在乳房切除术中的重建率较低.需要进一步的研究来了解BMI对ILC手术决策和结果的影响。
方法：对来自机构数据库的705例I-III期ILC患者进行回顾性分析。患者按BMI分层(体重不足，正常体重,超重,肥胖)。皮尔森卡方，方差分析,采用多变量logistic回归分析BMI与手术方式的关系。
结果：保乳手术（BCS）是60%患者的初始手术，BMI无显著差异。在那些接受BCS的人中，BMI肥胖的患者接受肿瘤整形手术的可能性更高(46.9%vs.7.7%,37.3%,体重过轻的占33.6%，正常,超重，分别,p=0.032)。与体重不足的患者相比，肥胖的BMI患者接受乳房切除术的可能性较小。正常体重,和超重的BMI(44.2%vs.50%,71.1%,和64.1%，p=0.002)。
结论：与BMI较低的患者相比，超重/肥胖的ILC患者接受了不同的手术干预。虽然最初的BCS率相似，超重/肥胖患者在BCS中的肿瘤再生手术率较高,在乳房切除术中的重建率较低.需要进一步的研究来了解BMI对ILC手术决策和结果的影响。
