BACKGROUND: Margin status is a significant risk factor for local recurrence. We sought to examine whether the method of tumor localization predicted the margin status and the need for re-excision for both nonpalpable and palpable breast cancer. METHODS: We identified 358 consecutive breast cancer patients who were treated with breast-conserving therapy (BCT) from 1999 to 2006. Data included patient and tumor characteristics, method of localization (needle versus palpation), and pathologic outcomes. Descriptive statistics were used for data summary and data were compared using χ(2). RESULTS: Of 358 patients undergoing BCT, 234 (65%) underwent needle localization for a nonpalpable tumor and 124 (35%) underwent a palpation-guided procedure. Patients undergoing palpation-guided procedures were younger and had larger tumors at a more advanced pathologic stage of disease than those undergoing needle localization procedures (P < 0.05 for each). Patient race, tumor grade, presence of lymphovascular invasion, biomarker profile, and nodal status were not significantly different between the two groups (P > 0.05). Overall, 137 patients (38%) had one or more positive margins: 90 of 234 (38%) who had a needle localization procedure and 47 of 124 (38%) who had a palpation-guided procedure (P > 0.05). The number of margins affected did not differ significantly between the two groups. CONCLUSION: Although patients with palpable breast cancer had larger tumors than those with nonpalpable breast cancer, the incidence and number of positive margins was similar to those who had needle localization for nonpalpable tumors. Improved methods of localization are needed to reduce the rate of positive margins and the need for re-excision.
BACKGROUND: Margin status is a significant risk factor for local recurrence. We sought to examine whether the method of tumor localization predicted the margin status and the need for re-excision for both nonpalpable and palpable breast cancer. METHODS: We identified 358 consecutive breast cancerpatients who were treated with breast-conserving therapy (BCT) from 1999 to 2006. Data included patient and tumor characteristics, method of localization (needle versus palpation), and pathologic outcomes. Descriptive statistics were used for data summary and data were compared using χ(2). RESULTS: Of 358 patients undergoing BCT, 234 (65%) underwent needle localization for a nonpalpable tumor and 124 (35%) underwent a palpation-guided procedure. Patients undergoing palpation-guided procedures were younger and had larger tumors at a more advanced pathologic stage of disease than those undergoing needle localization procedures (P < 0.05 for each). Patient race, tumor grade, presence of lymphovascular invasion, biomarker profile, and nodal status were not significantly different between the two groups (P > 0.05). Overall, 137 patients (38%) had one or more positive margins: 90 of 234 (38%) who had a needle localization procedure and 47 of 124 (38%) who had a palpation-guided procedure (P > 0.05). The number of margins affected did not differ significantly between the two groups. CONCLUSION: Although patients with palpable breast cancer had larger tumors than those with nonpalpable breast cancer, the incidence and number of positive margins was similar to those who had needle localization for nonpalpable tumors. Improved methods of localization are needed to reduce the rate of positive margins and the need for re-excision.
Authors: J A van Dongen; A C Voogd; I S Fentiman; C Legrand; R J Sylvester; D Tong; E van der Schueren; P A Helle; K van Zijl; H Bartelink Journal: J Natl Cancer Inst Date: 2000-07-19 Impact factor: 13.506
Authors: J A Jacobson; D N Danforth; K H Cowan; T d'Angelo; S M Steinberg; L Pierce; M E Lippman; A S Lichter; E Glatstein; P Okunieff Journal: N Engl J Med Date: 1995-04-06 Impact factor: 91.245
Authors: Emil D Kurniawan; Matthew H Wong; Imogen Windle; Allison Rose; Arlene Mou; Malcolm Buchanan; John P Collins; Julie A Miller; Russell L Gruen; G Bruce Mann Journal: Ann Surg Oncol Date: 2008-07-10 Impact factor: 5.344
Authors: J M Kurtz; J Jacquemier; R Amalric; H Brandone; Y Ayme; D Hans; C Bressac; J M Spitalier Journal: Ann Surg Date: 1990-07 Impact factor: 12.969
Authors: Funda Meric; Nadeem Q Mirza; Georges Vlastos; Thomas A Buchholz; Henry M Kuerer; Gildy V Babiera; S Eva Singletary; Merrick I Ross; Frederick C Ames; Barry W Feig; Savitri Krishnamurthy; George H Perkins; Marsha D McNeese; Eric A Strom; Vicente Valero; Kelly K Hunt Journal: Cancer Date: 2003-02-15 Impact factor: 6.860
Authors: Nicole M A Krekel; Barbara M Zonderhuis; Hermien W H Schreurs; Alexander M F Lopes Cardozo; Herman Rijna; Henk van der Veen; Sandra Muller; Pieter Poortman; Louise de Widt; Wilfred K de Roos; Anne Marie Bosch; Annette H M Taets van Amerongen; Elisabeth Bergers; Mecheline H M van der Linden; Elly S M de Lange de Klerk; Henri A H Winters; Sybren Meijer; Petrousjka M P van den Tol Journal: BMC Surg Date: 2011-03-16 Impact factor: 2.102
Authors: Kiranya E Tipirneni; Jason M Warram; Lindsay S Moore; Andrew C Prince; Esther de Boer; Aditi H Jani; Irene L Wapnir; Joseph C Liao; Michael Bouvet; Nicole K Behnke; Mary T Hawn; George A Poultsides; Alexander L Vahrmeijer; William R Carroll; Kurt R Zinn; Eben Rosenthal Journal: Ann Surg Date: 2017-07 Impact factor: 12.969
Authors: Rui Li; Lu Lan; Yan Xia; Pu Wang; Linda K Han; Gary L Dunnington; Samilia Obeng-Gyasi; George E Sandusky; Jennifer A Medley; Susan T Crook; Ji-Xin Cheng Journal: Med Devices Sens Date: 2018-10-26
Authors: Jennifer Yu; Leisha C Elmore; Amy E Cyr; Rebecca L Aft; William E Gillanders; Julie A Margenthaler Journal: J Am Coll Surg Date: 2017-04-14 Impact factor: 6.113
Authors: Banghe Zhu; Grace Wu; Holly Robinson; Nathaniel Wilganowski; Mary A Hall; Sukhen C Ghosh; Kenneth L Pinkston; Ali Azhdarinia; Barrett R Harvey; Eva M Sevick-Muraca Journal: Mol Imaging Biol Date: 2013-10 Impact factor: 3.488
Authors: Tone F Bathen; Brigitte Geurts; Beathe Sitter; Hans E Fjøsne; Steinar Lundgren; Lutgarde M Buydens; Ingrid S Gribbestad; Geert Postma; Guro F Giskeødegård Journal: PLoS One Date: 2013-04-17 Impact factor: 3.240
Authors: Woohyun Jung; Eunyoung Kang; Sun Mi Kim; Dongwon Kim; Yoonsun Hwang; Young Sun; Cha Kyong Yom; Sung-Won Kim Journal: J Breast Cancer Date: 2012-12-31 Impact factor: 3.588