Literature DB >> 11320515

Relationship between excision volume, margin status, and tumor size with the development of local recurrence in patients with ductal carcinoma-in-situ treated with breast-conserving therapy.

F A Vicini1, L L Kestin, N S Goldstein, K L Baglan, J E Pettinga, A A Martinez.   

Abstract

BACKGROUND AND OBJECTIVES: We reviewed our institution's experience treating patients with ductal carcinoma-in-situ (DCIS) with breast-conserving therapy (BCT) to help define the interrelationship between excision volume, margin status, and tumor size with local recurrence.
METHODS: From January 1980 to December 1993, 146 patients received BCT for DCIS. All patients underwent excisional biopsy and 95 cases (64%) underwent re-excision. Each patient received whole breast radiation to a median dose of 45 Gy. An additional 139 cases (94%) received a supplemental boost to the tumor bed (median total dose 60.4 Gy). The median follow-up is 7.2 years.
RESULTS: Seventeen patients developed an ipsilateral breast failure for a 5- and 10-year actuarial rate of 10.2 and 12.4%, respectively. On multivariate analysis, patient age, margin status, the number of slides containing DCIS, the number of DCIS/cancerization of lobules (COL) foci near (< 5 mm) the margin, and a smaller volume of excision (< 60 cm(3)) were all independently associated with outcome. Although the local recurrence rate generally decreased as margin distance increased, these differences did not achieve statistical significance unless the volume of excision was taken into consideration.
CONCLUSIONS: These findings suggest that the success of BCT is directly related to the degree of surgical removal of DCIS and that margin status alone may be suboptimal in defining excision adequacy. Copyright 2001 Wiley-Liss, Inc.

Entities:  

Mesh:

Year:  2001        PMID: 11320515     DOI: 10.1002/jso.1041

Source DB:  PubMed          Journal:  J Surg Oncol        ISSN: 0022-4790            Impact factor:   3.454


  14 in total

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Authors:  Bruce G Haffty; Sharad Goyal; Diptee Kulkarni; Camille Green; Alexi Vazquez; Devora Schiff; Meena S Moran; Qifeng Yang; Shridar Ganesan; Kim M Hirsfield
Journal:  Int J Radiat Oncol Biol Phys       Date:  2010-06-18       Impact factor: 7.038

2.  Evaluation of surgical outcomes following oncoplastic breast surgery in early breast cancer and comparison with conventional breast conservation surgery.

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3.  Magnetic resonance imaging captures the biology of ductal carcinoma in situ.

Authors:  Laura J Esserman; Anjali S Kumar; Alex F Herrera; Jessica Leung; Alfred Au; Yunn-Yi Chen; Dan H Moore; Daniel F Chen; Jennifer Hellawell; Dulcy Wolverton; E Shelley Hwang; Nola M Hylton
Journal:  J Clin Oncol       Date:  2006-10-01       Impact factor: 44.544

Review 4.  Association between patient and tumor characteristics with clinical outcomes in women with ductal carcinoma in situ.

Authors:  Tatyana Shamliyan; Shi-Yi Wang; Beth A Virnig; Todd M Tuttle; Robert L Kane
Journal:  J Natl Cancer Inst Monogr       Date:  2010

5.  Role of boost radiotherapy for local control of pure ductal carcinoma in situ after breast-conserving surgery: a multicenter, retrospective study of 622 patients.

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Review 6.  Intraoperative imprint cytology and frozen section pathology for margin assessment in breast conservation surgery: a systematic review.

Authors:  Karla Esbona; Zhanhai Li; Lee G Wilke
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7.  Multiple margin positivity of frozen section is an independent risk factor for local recurrence in breast-conserving surgery.

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8.  Relationship Between Margin Width and Recurrence of Ductal Carcinoma In Situ: Analysis of 2996 Women Treated With Breast-conserving Surgery for 30 Years.

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9.  High and intermediate grade ductal carcinoma in-situ of the breast: a comparison of pathologic features in core biopsies and excisions and an evaluation of core biopsy features that may predict a close or positive margin in the excision.

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Journal:  Diagn Pathol       Date:  2009-08-19       Impact factor: 2.644

10.  Radiological and pathological size estimations of pure ductal carcinoma in situ of the breast, specimen handling and the influence on the success of breast conservation surgery: a review of 2564 cases from the Sloane Project.

Authors:  J Thomas; A Evans; J Macartney; S E Pinder; A Hanby; I Ellis; O Kearins; T Roberts; K Clements; G Lawrence; H Bishop
Journal:  Br J Cancer       Date:  2010-01-05       Impact factor: 7.640

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