Positive Tumor Margins in Wide Local Excision of Breast Cancer: A 10-Year Retrospective Study

Abstract

Background. The safety of wide local excision as a standard surgical option for early stage breast cancer management in Ghana has not been evaluated. The aim of this study was to use retrospective histopathological descriptive study to evaluate the prevalence of positive tumor margins in wide local excision specimens and offer recommendations. Study design. We reviewed 147 breast lumps, following wide local excision, which were received in the Department of Pathology, for positive tumor margins. The data was analyzed using SPSS software (version 16). Results. A total of 2,751 female breast cancers were diagnosed during the study period, of which 147 (5.3%) were from wide local excisions (lumpectomies). Thirty-one (21.0%) had positive tumor margins. The mean age of women with positive margins was 53.4 (SD = 17.1) years. The mean size of primary tumor was 4.0 (SD = 2.1) cm, the majority (53.0%) of which were greater than 2.0 cm, but less than or equal to 5.0 cm (T2). A total of 26 (83.4%) of these tumors were invasive ductal carcinomas (NOS), 24 (92.3%) of the cases had combined Bloom-Richardson grading, and many, 10 (41.7%), were grade 1. Conclusion. Our study shows that 21.0% of all wide local excision biopsies had positive tumor margins, a figure that is comparable to those of other studies. Tumors with positive margins in this study were large, 4.0 cm (T2), and common in relatively young women. Treatment failure is therefore likely to occur in these patients.

Invasive intracystic papillary carcinoma of the male breast: A case report of a 79 year male with advanced breast cancer at presentation

“…Nodal involvement by malignant tumour and the presence of positive tumour margins are indicators of systemic disease, recurrence after surgery and treatment failure. [21][22][23] The immunohistochemical profile of this case is in keeping with a previous study conducted at the Korle-Bu teaching Accra Ghana on MBCs. [9,24] The breast cancer by pathological staging was of a high stage (pT4bN1M), in keeping with reports on male breast cancer.…”

“…[27] Our patient has most of these poor prognostic indicators. [22][23][24][25][26][27][28] For instance, he was 79-years with large tumour size, skin ulceration, fixation to the anterior chest wall with high pathological stage at diagnosis and hence the poor outcome (death) in this case.…”

Breast Malignancies in Northern Ghana: A 7-Year Histopathological Review at The Tamale Teaching Hospital (2013 – 2019)

“…44,45 However, the rate varies globally based on the study types and methods. 14,46 In this current study conducted in the northern part of Ghana, the prevalence of positive tumour margins in large samples was 35.2%.This rate is much higher than what was reported in previous studies in Ghana. 14,46 For instance, Der et al, 46 in Accra Ghana reported a rate of 21.1% in wide local excision specimens.…”

The pattern of thyroid cancers in Nigeria: a systematic review and meta-analysis

“…This is similar to what Der et al documented in Ghana (4:1) and t Seyoum et al documented in Ethiopia (4.1:1) respectively. 37,43 It has been richly documented in the literature that thyroid cancers is commoner among females. 37,44−47 According to Rahbari et al, it is only the differentiated thyroid cancer that is commoner in females with the poorly differentiated subtype having equal gender distribution.…”