Literature DB >> 8257222

Incidence of gross and microscopic carcinoma in specimens from patients with breast cancer after re-excision lumpectomy.

J L Gwin1, B L Eisenberg, J P Hoffman, F D Ottery, M Boraas, L J Solin.   

Abstract

OBJECTIVE: The aims of this study were to quantify the amount of the residual carcinoma in re-excision lumpectomy specimens and retrospectively analyze the relationship between clinical parameters and the characteristics of the primary excision to these quantities of the residual tumor. SUMMARY BACKGROUND DATA: Because complete gross surgical excision of the primary tumor is important in minimizing local recurrence in women undergoing breast conservation therapy, re-excision of the initial biopsy site is commonly practiced when the initial primary tumor excision shows inadequate or undeterminable margins. Several studies have reported a significant proportion of re-excision specimens to contain residual tumor (32% to 63%), but to the authors' knowledge, none have quantified the amount of residual tumor.
METHODS: The authors reviewed 192 re-excisions retrospectively to quantify the amount of residual carcinoma and correlate the quantities with the characteristics of the primary tumor resection.
RESULTS: No tumor was found in 105 (54.7%) specimens, 46 (23.9%) had minimal microscopic disease, 23 (12.0%) had extensive microscopic disease, and 18 (9.4%) had gross residual cancer. Characteristics significantly associated with the quantity of residual disease included clinical tumor stage (T stage), pathologic T stage, and the margin status of the primary excision. The majority (62.1%) of re-excision specimens containing residual carcinoma had an invasive component.
CONCLUSIONS: It was concluded that re-excision lumpectomy yields an important number of patients with residual carcinoma and that characteristics of both the primary tumor and primary excision significantly predict the quantity of residual cancer in the specimen. In addition, these results support the policy of performing re-excision for patients with inadequate or undeterminable margins for the primary excision.

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Year:  1993        PMID: 8257222      PMCID: PMC1243067          DOI: 10.1097/00000658-199312000-00005

Source DB:  PubMed          Journal:  Ann Surg        ISSN: 0003-4932            Impact factor:   12.969


  17 in total

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Journal:  Int J Radiat Oncol Biol Phys       Date:  1987-11       Impact factor: 7.038

3.  Pathologic findings on re-excision of the primary site in breast cancer patients considered for treatment by primary radiation therapy.

Authors:  S J Schnitt; J L Connolly; U Khettry; G Mazoujian; M Brenner; B Silver; A Recht; G Beadle; J R Harris
Journal:  Cancer       Date:  1987-02-15       Impact factor: 6.860

4.  Analysis of local-regional relapses in patients with early breast cancers treated by excision and radiotherapy: experience of the Institut Gustave-Roussy.

Authors:  D H Clarke; M G Lê; D Sarrazin; M J Lacombe; F Fontaine; J P Travagli; F May-Levin; G Contesso; R Arriagada
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5.  Prognostic factors for recurrence and cosmesis in 393 patients after radiation therapy for early mammary carcinoma.

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6.  Patterns of local-regional recurrence and results in Stages I and II breast cancer treated by irradiation following limited surgery. An update.

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7.  Lumpectomy and level I axillary dissection prior to irradiation for "operable" breast cancer.

Authors:  G F Schwartz; A L Rosenberg; B F Danoff; C M Mansfield; S A Feig
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8.  Irradiation as the primary management of stage I and II adenocarcinoma of the breast: analysis of the RTOG breast registry.

Authors:  J M Bedwinek; L Brady; C A Perez; R Goodman; S Kramer; G Grundy
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9.  Histologic multifocality of Tis, T1-2 breast carcinomas. Implications for clinical trials of breast-conserving surgery.

Authors:  R Holland; S H Veling; M Mravunac; J H Hendriks
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10.  Results of re-excisional biopsy of the primary tumor in preparation for definitive irradiation of patients with early stage breast cancer.

Authors:  L J Solin; B Fowble; K Martz; T F Pajak; R L Goodman
Journal:  Int J Radiat Oncol Biol Phys       Date:  1986-05       Impact factor: 7.038

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7.  Accuracy of Specimen Radiography in Assessing Complete Local Excision with Breast-Conservation Surgery

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