Impacts of Surgical Margin Status in Breast-conserving Surgery on Local Recurrence

2009 ◽  
Vol 75 (3) ◽  
pp. S221
Author(s):  
T. Han ◽  
E. Chie ◽  
S. Ha
Keyword(s):  
Local Recurrence ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Margin Status

Outcome at 8 Years After Breast-Conserving Surgery and Radiation Therapy for Invasive Breast Cancer: Influence of Margin Status and Systemic Therapy on Local Recurrence

2000 ◽  
Vol 18 (8) ◽  
pp. 1668-1675 ◽  
Author(s):  
Catherine C. Park ◽  
Michihide Mitsumori ◽  
Asa Nixon ◽  
Abram Recht ◽  
James Connolly ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Radiation Therapy ◽  
Local Recurrence ◽  
Systemic Therapy ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Margin Status ◽  
Positive Margins

PURPOSE: To examine the relationship between pathologic margin status and outcome at 8 years after breast-conserving surgery and radiation therapy. PATIENTS AND METHODS: The study population comprised 533 patients with International Union Against Cancer/American Joint Committee on Cancer clinical stage I or II breast cancer who had assessable margins, who received at least 60 Gy to the primary tumor bed, and who had more than 8 years of potential follow-up. Each margin was scored (according to the presence of invasive or in situ disease that touched the inked surgical margin) as one of the following: negative, close, focally positive, or extensively positive. Outcome at 8 years was calculated using crude rates of first site of failure. A polychotomous logistic regression analysis was performed. Median follow-up time was 127 months. RESULTS: At 8 years, patients with close margins and those with negative margins both had a rate of local recurrence (LR) of 7%. Patients with extensively positive margins had an LR rate of 27%, whereas patients with focally positive margins had an intermediate rate of LR of 14%. In the polychotomous logistic regression model, margin status and the use of systemic therapy were the only two variables that had significant effects on the risk ratio of LR to remaining alive and free of disease. Among the 45 patients with focally positive margins who received systemic therapy, the crude LR rate was 7% at 8 years (95% confidence interval, 1% to 20%). CONCLUSION: Pathologic margin status and the use of adjuvant systemic therapy are the most important factors associated with LR among patients treated with breast-conserving surgery and radiation therapy.

The effect of margin status on local recurrence following breast conservation and radiation therapy for DCIS

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 597-597
Author(s):  
M. R. Kell ◽  
C. Dunne ◽  
C. Canning ◽  
M. Morrow
Keyword(s):  
Local Recurrence ◽  
Randomized Trials ◽  
Ductal Carcinoma ◽  
Breast Conservation ◽  
Significant Risk ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Margin Status ◽  
Surgical Margins ◽  
Significant Difference

597 Background: There is no consensus on what constitutes an adequate surgical margin in patients receiving breast conserving surgery (BCS) and postoperative irradiation (RT) for ductal carcinoma in situ (DCIS). Inadequate margins may result in high local recurrence, and excessively large resections may lead to poor cosmetic outcome without oncological benefit. Methods: A comprehensive search for published trials which examined outcomes after adjuvant RT following BCS for DCIS was performed using medline and cross referencing available data. Reviews of each study were conducted, and data were extracted. Fixed and random effects methods were used to combine data. Primary outcomes were in breast tumour recurrence (IBTR) related to surgical margins. Results: Analysis of 3,606 patients from randomized trials confirms that patients with negative margins are significantly less likely to recur than those with positive margins after RT (RR 0.53, 95% CI= 0.42 to 0.66, p<0.01). Combined data from randomized and non randomized trials, of 5,500 patients, demonstrates that where the margin status is close or unknown there is significant risk of IBTR compared to a negative margin (RR=1.68, 95% CI= 1.22–2.33, p<0.01). When specific margin thresholds are examined a 2 mm margin is superior to less than 2 mm (OR=0.67, 95% CI 0.51 -0.89, p<0.01), however we saw no significant difference in the rate of IBTR between a 2 mm margin and >5 mm (OR=1.49, 95% CI 0.54 to 4.9, p>0.05). Conclusions: Surgical margins negative for DCIS should be obtained following BCS for DCIS. A margin threshold of 2mm appears be as good as a larger margin when BCS for DCIS is combined with RT. No significant financial relationships to disclose.

The surgical margin status after breast-conserving surgery: discussion of an open issue

2008 ◽  
Vol 113 (2) ◽  
pp. 397-402 ◽  
Author(s):  
Alberto Luini ◽  
Joel Rososchansky ◽  
Giovanna Gatti ◽  
Stefano Zurrida ◽  
Pietro Caldarella ◽  
...  
Keyword(s):  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Margin Status ◽  
Open Issue

Neither Surgical Margin Status nor Somatic Mutation Predicts Local Recurrence After R0-intent Resection for Colorectal Liver Metastases

2021 ◽  
Author(s):  
Yujiro Nishioka ◽  
Natalia Paez-Arango ◽  
Federico Oppliger Boettcher ◽  
Yoshikuni Kawaguchi ◽  
Timothy E. Newhook ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Liver Metastases ◽  
Somatic Mutation ◽  
Colorectal Liver Metastases ◽  
Surgical Margin ◽  
Margin Status

The Analysis of Preoperative Wire Localization in Breast Conserving Surgery and Predictors of Surgical Margin Status

2021 ◽  
Vol 104 (10) ◽  
pp. 1617-1625
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Tumor Resection ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Margin Status ◽  
Positive Surgical Margin ◽  
Architectural Distortion ◽  
Wire Localization ◽  
Large Tumor

Background: At present, the breast conserving therapy (BCT) is considered a treatment of choice for early-stage breast cancer. BCT aims to achieve complete tumor resection with adequate margin and offers better cosmetic outcome. Objective: To describe the experience with preoperative wire localization technique for early breast cancer and analysis of factors affecting positive margin status. Materials and Methods: The authors retrospectively reviewed 190 patients with 206 malignant breast lesions treated by breast conserving surgery (BCS) after mammographic- or ultrasound- guided wire localization. Patient age, lesion type such as mass, mass with calcifications, calcifications alone, and architectural distortion, BI-RADS assessment categories, size, location, modalities of imaging guidance, number of wires used, radiological and surgical margin status, pathological diagnosis, and tumor focality were recorded. Results: A 14.56% of positive surgical margin rate was observed. Mixed-effects logistic regression analysis showed larger lesion size was a significant predictor for positive surgical margin status at larger than 1.5 cm versus 1.0 cm or smaller (p=0.033). Conclusion: The present study data suggested that larger tumor size is the only significant predictor for positive surgical margin status. To deal with non-palpable large tumor, surgeon and radiologist should pay particular attention to achieve adequate surgical margin. Keywords: Wire localization; Breast conserving surgery; Surgical margin status; Specimen radiography

scholarly journals Association Between Surgical Margin Status and Local Recurrence in Iranian Patients Suffering from Colorectal Cancer

2018 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Narges Sistany Allahabadi ◽  
Hossein Yahyazadeh ◽  
Hossein Pourtavakoli ◽  
Azita Abdollahinejad ◽  
Marzieh Beheshti
Keyword(s):  
Colorectal Cancer ◽  
Local Recurrence ◽  
Surgical Margin ◽  
Margin Status ◽  
Iranian Patients

40. Surgical margin status after breast conserving surgery and presence of residual disease

2016 ◽  
Vol 42 (9) ◽  
pp. S81-S82
Author(s):  
E. Vos ◽  
J. Gaal ◽  
C. Verhoef ◽  
C. Van Deurzen ◽  
L. Koppert
Keyword(s):  
Residual Disease ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Margin Status

scholarly journals Towards a personalized surgical margin for breast conserving surgery-Implications of field cancerization in local recurrence

2017 ◽  
Vol 115 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Katarina Lebya ◽  
Randi Garcia-Smith ◽  
Radha Swaminathan ◽  
Anna Jones ◽  
John Russell ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Field Cancerization

scholarly journals “Unplanned breast-conserving surgery after systemic therapy in locally advanced breast cancer: the results of level II oncoplastic techniques”

2021 ◽  
Author(s):  
mehmet gulcelik ◽  
Lütfi Doğan
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
Locally Advanced ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Margin Status ◽  
Axillary Recurrence ◽  
Free Survival ◽  
Level Ii ◽  
Significant Difference

BACKGROUND: In patients with breast cancer for whom neoadjuvant chemotherapy (NAC) is planned, it is recommended to mark the primary tumor before treatment (planned surgery). However, surgeons may have to perform breast-conserving surgery on patients whose tumors are not marked (unplanned surgery). This study focused on the results obtained with planned and unplanned level II oncoplastic surgery (OPS) techniques applied to patients after NAC. METHODS: Patient groups who underwent planned, unplanned OPS and mastectomy after NAC were compared. Surgical margin status, re-operation and re-excision requirements, ipsilateral breast tumor recurrence (IBTR) and axillary recurrence rates recorded. Long-term local recurrence-free survival (LRFS), disease-free survival and overall survival were evaluated. RESULTS: There was no significant difference between the planned and unplanned OPS groups in terms of surgical margin status, re-excision requirement, and mastectomy rates. During an average follow-up period of 43 months, 5.3% and 4% of the patients in the planned OPS group developed IBTR and axillary recurrence, respectively, whereas these rates were 6.6% and 5.3% in the unplanned OPS group. In the mastectomy group, the rates of IBTR and axillary recurrence were found to be 4.1% and 3.8%, respectively. There was no significant difference between the three groups in terms of IBTR (p: 0.06) and axillary recurrence (p: 0.08) rates. CONCLUSION: Breast conserving surgery can be applied using level II OPS techniques with the post-NAC radiological examination and marking even if primary tumor marking is not done in the pre-NAC period.

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