BACKGROUND: A significant proportion of patients undergoing breast conservation therapy require additional operations to obtain clear margins. The aim of this study was to assess the impact of initial margins and residual carcinoma found on second surgery on the outcomes of breast cancer patients. METHODS: In this retrospective study, Cox proportional-hazard regression analysis was performed to evaluate data from 437 patients with stage I to IIIA breast cancer who underwent initial breast-conserving surgery between 1994 and 2004. RESULTS: The distant recurrence rate was higher among patients with initial positive margins than among those with initial negative margins (15.5% vs 4.9%; hazard ratio, 3.6; 95% confidence interval 1.5-8.7; P = .003). For patients who had underwent second surgery, the finding of a residual invasive carcinoma was associated with increased risk for distant recurrence (22.8% vs 6.6%; hazard ratio, 3.5; 95% confidence interval, 1.8-7.4; P = .0001). CONCLUSION: Invasive residual carcinoma found during subsequent surgery after initial compromised margins is an important prognostic marker for distant recurrence.
BACKGROUND: A significant proportion of patients undergoing breast conservation therapy require additional operations to obtain clear margins. The aim of this study was to assess the impact of initial margins and residual carcinoma found on second surgery on the outcomes of breast cancerpatients. METHODS: In this retrospective study, Cox proportional-hazard regression analysis was performed to evaluate data from 437 patients with stage I to IIIA breast cancer who underwent initial breast-conserving surgery between 1994 and 2004. RESULTS: The distant recurrence rate was higher among patients with initial positive margins than among those with initial negative margins (15.5% vs 4.9%; hazard ratio, 3.6; 95% confidence interval 1.5-8.7; P = .003). For patients who had underwent second surgery, the finding of a residual invasive carcinoma was associated with increased risk for distant recurrence (22.8% vs 6.6%; hazard ratio, 3.5; 95% confidence interval, 1.8-7.4; P = .0001). CONCLUSION: Invasive residual carcinoma found during subsequent surgery after initial compromised margins is an important prognostic marker for distant recurrence.
Authors: Julia Parrish-Novak; Kelly Byrnes-Blake; Narine Lalayeva; Stefanie Burleson; Janean Fidel; Rhonda Gilmore; Pamela Gayheart-Walsten; Gregory A Bricker; William J Crumb; K S Tarlo; Stacey Hansen; Valorie Wiss; Errol Malta; William S Dernell; James M Olson; Dennis M Miller Journal: Int J Toxicol Date: 2017-03-17 Impact factor: 2.032
Authors: Jennifer M Racz; Amy E Glasgow; Gary L Keeney; Amy C Degnim; Tina J Hieken; James W Jakub; John C Cheville; Elizabeth B Habermann; Judy C Boughey Journal: Ann Surg Oncol Date: 2020-07-04 Impact factor: 5.344
Authors: Ken Y Foo; Kyle Newman; Qi Fang; Peijun Gong; Hina M Ismail; Devina D Lakhiani; Renate Zilkens; Benjamin F Dessauvagie; Bruce Latham; Christobel M Saunders; Lixin Chin; Brendan F Kennedy Journal: Biomed Opt Express Date: 2022-05-12 Impact factor: 3.562
Authors: Edward R St John; Julia Balog; James S McKenzie; Merja Rossi; April Covington; Laura Muirhead; Zsolt Bodai; Francesca Rosini; Abigail V M Speller; Sami Shousha; Rathi Ramakrishnan; Ara Darzi; Zoltan Takats; Daniel R Leff Journal: Breast Cancer Res Date: 2017-05-23 Impact factor: 6.466
Authors: R Jeevan; D A Cromwell; M Trivella; G Lawrence; O Kearins; J Pereira; C Sheppard; C M Caddy; J H P van der Meulen Journal: BMJ Date: 2012-07-12