The unsatisfactory margin in breast cancer surgery

Luu, Han H; Otis, Christopher N.; Reed, William P.; Garb, Jane; Frank, James L.

doi:10.1016/s0002-9610(99)00198-1

Cited by 87 publications

(38 citation statements)

References 23 publications

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“…Tumor size was found to be associated with positive surgical margins by Peterson et al, [5] Park et al [6] and Tartter et al [7] by univariate analysis. Tartter et al [7] and Luu et al [8] demonstrated by multivariate analysis also, that tumor size showed a significant correlation with surgical margins.…”

Section: Discussionmentioning

confidence: 91%

Feasibility of breast conservation surgery in locally advanced breast cancer downstaged by neoadjuvant chemotherapy: A study in mastectomy specimens using simulation lumpectomy

et al. 2005

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Section: Discussionmentioning

confidence: 91%

Feasibility of breast conservation surgery in locally advanced breast cancer downstaged by neoadjuvant chemotherapy: A study in mastectomy specimens using simulation lumpectomy

et al. 2005

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“…Several studies have addressed the question of patient or tumor characteristics associated with positive lumpectomy margins. By multivariate analysis, positive lumpectomy margins were associated with large tumor size 20,21 and the presence of an extensive intraductal component. 21 Similarly, positive cavity margins were reported to be associated with large tumor size and tumor type (intraductal carcinoma, invasive lobular carcinoma) by multivariate analysis.…”

Section: Discussionmentioning

confidence: 97%

“…By multivariate analysis, positive lumpectomy margins were associated with large tumor size 20,21 and the presence of an extensive intraductal component. 21 Similarly, positive cavity margins were reported to be associated with large tumor size and tumor type (intraductal carcinoma, invasive lobular carcinoma) by multivariate analysis. 7 Our results are concordant, as the distance of the initial lumpectomy margin to the carcinoma, the larger size of the tumor and metastatic axillary lymph node appeared as factors associated with positive cavity margins in univariate analysis whereas the latter two were only associated by multivariate analysis.…”

Section: Discussionmentioning

confidence: 97%

Prevalence and predictive factors for the detection of carcinoma in cavity margin performed at the time of breast lumpectomy

et al. 2009

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Margin resection status is a major risk factor for the development of local recurrence in breast conservation therapy for carcinoma. Tumor bed excision sent as separate orientated cavity margins represents a tool to verify the completeness of the carcinoma resection. We aimed to (1) determine the prevalence of positive cavity margin and its influence on subsequent surgical treatment and (2) identify potential predictive factors for positive cavity margins. From 2003From to 2006 30-88) consecutive patients who underwent a lumpectomy for carcinoma with four orientated cavity margins for carcinoma were selected. Preoperative clinical, radiological and histological data, perioperative macroscopic characteristics and definitive histological analysis results were recorded. Lumpectomy or cavity margins were considered as positive when the distance from carcinoma to the margin was less than or equal to 3 mm. Histological examination of cavity margins showed carcinoma in 38 patients (35%), therefore modifying subsequent surgical therapy in 33 cases. Examination of the cavity margins led (1) to avoiding surgical re-excision in 20 cases (lumpectomy margins were positive and the cavity margins negative), (2) to performing a mastectomy or a re-excision in 13 cases (carcinoma was detected in the cavity margins although the lumpectomy margins were negative or tumor size was superior to 3 cm). Between preoperative and perioperative parameters, US scan and macroscopic size of the tumor were predictive factors for positive cavity margins whereas characteristics of the carcinoma determined on biopsy samples and macroscopic status of the lumpectomy margins were not. Our study confirms that the systematic practice of cavity margin resection avoids surgical re-excision and reduces the likelihood of underestimating the extent of the tumor.

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“…From these data, it is clear that resection margin less than 5 mm is definitely not sufficient to achieve tumor negative breast after surgical procedure [17][18] . The other important question is, however, whether obtaining free resection margin will have an impact on local recurrence rate and subsequently on overall survival of breast cancer patients [19][20][21][22][23][24][25][26][27] . All patients undergoing breast conserving surgery are indicated for adjuvant radiotherapy (considering that adjuvant radiotherapy may be omitted in older patients 28 ).…”

Section: Discussionmentioning

confidence: 99%

Significance of resection margin as a risk factor for local control of early stage breast cancer

Gatěk¹,

Vrána²,

Lukešová³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Introduction. Breast conserving surgery combined with sentinel node biopsy represents currently the gold standard of treatment for early breast cancer. Although breast conserving surgery has been a widely accepted method for many years, there remain some highly controversial unresolved issues. The present analysis focused on the resection margin as one of the key factors for local control of the disease. Methods. Patient disease free survival and overall survival were collected from patients undergoing breast conserving surgery from 2004 to 2009 at the Department of Surgery Atlas hospital Zlin, Czech Republic. All patients with resection margin less then 5 mm were re-resected to achieve this clear resection margin of 5mm or more. Disease free survival (more specifically local relapse free survival, metastasis free survival and regional free survival) and overall survival were assessed. Results. The data on 330 patients were analyzed and 286/330 cases had complete follow-up. After a median follow-up of 70 months, 7 patients with isolated local relapse were identified (2.44%), 13 patients with distant metastasis without local relapse (4.54%) and 2 patients with relapse in the axilla without local relapse in the breast (0.7%). Conclusion.The final decision about the extent of resection margin remains controversial but based on the data on local control presented here it seems reasonable to increase the criteria for a clear resection margin to 5 mm.

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The unsatisfactory margin in breast cancer surgery

Cited by 87 publications

References 23 publications

Feasibility of breast conservation surgery in locally advanced breast cancer downstaged by neoadjuvant chemotherapy: A study in mastectomy specimens using simulation lumpectomy

Feasibility of breast conservation surgery in locally advanced breast cancer downstaged by neoadjuvant chemotherapy: A study in mastectomy specimens using simulation lumpectomy

Prevalence and predictive factors for the detection of carcinoma in cavity margin performed at the time of breast lumpectomy

Significance of resection margin as a risk factor for local control of early stage breast cancer

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