Subsets of Women with Close or Positive Margins after Breast Conserving Surgery with High Local Recurrence Risk Despite Breast Plus Boost Radiotherapy

2010 ◽  
Vol 78 (3) ◽  
pp. S52-S53 ◽  
Author(s):  
P. Truong ◽  
K. Lupe ◽  
C. Alexander ◽  
M. Lesperance ◽  
S. Tyldesley
Keyword(s):  
Local Recurrence ◽  
Recurrence Risk ◽  
Breast Conserving Surgery ◽  
Positive Margins ◽  
Boost Radiotherapy

Focally positive margins in breast conserving surgery: Predictors, residual disease, and local recurrence

2017 ◽  
Vol 43 (10) ◽  
pp. 1846-1854 ◽  
Author(s):  
E.L. Vos ◽  
J. Gaal ◽  
C. Verhoef ◽  
K. Brouwer ◽  
C.H.M. van Deurzen ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Residual Disease ◽  
Breast Conserving Surgery ◽  
Positive Margins

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.

scholarly journals Comparison of Local Recurrence Risk Estimates After Breast-Conserving Surgery for DCIS: DCIS Nomogram Versus Refined Oncotype DX Breast DCIS Score

2019 ◽  
Vol 26 (10) ◽  
pp. 3282-3288 ◽  
Author(s):  
Kimberly J. Van Zee ◽  
Emily C. Zabor ◽  
Rosemarie Di Donato ◽  
Bryan Harmon ◽  
Jana Fox ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Recurrence Risk ◽  
Breast Conserving Surgery ◽  
Oncotype Dx ◽  
Risk Estimates

The influence of margin width and volume of disease near margin on benefit of radiation therapy after breast-conserving surgery for DCIS: Results of long-term follow-up

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 531-531
Author(s):  
U. Rudloff ◽  
E. Brogi ◽  
B. McCormick ◽  
J. P. Brockway ◽  
J. I. Goldberg ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Ipsilateral Breast Tumor Recurrence ◽  
Recurrence Risk ◽  
Breast Conserving Surgery ◽  
Added Value ◽  
Palpable Mass ◽  
Margin Width ◽  
Long Term Follow Up

531 Background: There remains variation in the use of radiation (RT) in women with DCIS, despite prospective randomized trials documenting its benefit in reducing the risk of ipsilateral breast tumor recurrence (IBTR). Methods: Patients with DCIS treated with excision alone or excision plus radiation at our institution from 1991–1995 were identified. A dedicated breast pathologist assessed margin width, number of involved ducts at closest margin, nuclear grade, and presence of necrosis and lobular neoplasia. Pathological variables, age, and presence of palpable mass were tested in uni- and multivariate analysis for association with risk of IBTR and added value of RT. Results: 294 patients with a median follow-up of 11 years had actuarial 10- and 15-year overall IBTR rates of 22 and 29%. For lesions excised with margins of <1mm, 1–9mm, and ≥10mm, the actuarial 10-year IBTR rates were 28, 21, and 19%, respectively. RT reduced adjusted IBTR rates by 62% (12 vs. 28%; p=0.002) for all patients; 83% for lesions with <1mm margins (p=0.002), 70% for 1–9mm (p=0.05), and 27% (p=0.55) for ≥10mm. Following adjustment for other variables, higher volume of disease near the margin was associated with risk of IBTR in the no RT group (HR=3.37, p=0.002) and greater benefit of RT (HR 0.14; p=0.004). Conclusions: Effect of RT on local recurrence risk is influenced by both margin width and number of involved ducts at nearest margin. Patients with higher volume of disease near the margin derive a greater benefit from the addition of RT. Despite margins of ≥10mm, the risk of local recurrence remains substantial in patients with DCIS. [Table: see text] No significant financial relationships to disclose.

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