Radiation therapy without boost for breast conserving surgery patients with positive surgical margin or extensive intraductal component

1998 ◽  
Vol 34 ◽  
pp. S62 ◽  
Author(s):  
K. Mivauchi ◽  
Y. Takatsuka ◽  
Y. Maeura ◽  
T. Alkawa ◽  
H. Ymamamoto ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Positive Surgical Margin ◽  
Extensive Intraductal Component ◽  
Intraductal Component

BENEFIT OF ADJUVANT RADIATION THERAPY FOR LOCALIZED PROSTATE CANCER WITH A POSITIVE SURGICAL MARGIN

2000 ◽  
pp. 1178-1182 ◽  
Author(s):  
BRADLEY C. LEIBOVICH ◽  
DONALD E. ENGEN ◽  
DAVID E. PATTERSON ◽  
THOMAS M. PISANSKY ◽  
ERIK E. ALEXANDER ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Surgical Margin ◽  
Localized Prostate Cancer ◽  
Positive Surgical Margin ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy

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 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

Predictive factor for residual tumor after lumpectomy for close margins

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11538-e11538
Author(s):  
V. Ozmen ◽  
S. Ozkan Gurdal ◽  
M. Muslumanoglu ◽  
A. Igci ◽  
S. S. Tuzlali ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Ductal Carcinoma ◽  
Residual Disease ◽  
Surgical Margin ◽  
Residual Tumor ◽  
Excisional Biopsy ◽  
Breast Conserving Surgery ◽  
Positive Surgical Margin ◽  
Breast Cancer Patients

e11538 Background: It is critical to obtain clear margins to minimize local recurrence after breast conserving surgery(BCS). When re-excisions are performed, there is often no residual disease in the new specimen, calling into question the need for re-excision(s) or mastectomy. The aim of the present study was to identify factors predicting a histologically positive re-excision specimen. Methods: Our prospective breast cancer database was queried for all invasive breast cancer patients who underwent a re-excision lumpectomy for either close or positive margins after an attempt at BCS. Close margins are defined as ≤ 2 mm for invasive carcinoma and presence of ductal carcinoma in situ(DCIS). Clinicopathologic features were correlated with the presence of residual disease in the re-excision specimen. Results: Between February 1997 and August 2008, 2054 patients with early breast cancer underwent surgical treatment in our breast unit. 939(45.7%) of them had BCS. In 543 patients(26.4%), re-excision required due to close margins on the permanent section analysis of their initial surgical specimens. 186 patients(34.3%) had previous excisional biopsy in other clinics. Median age of 543 patients was 50 years. In 290 patients(53.4%), mastectomy was performed due to positive surgical margin or poor cosmetic results. There were no residual tumors in re-excision(65.6 %) or mastectomy(42.4%) specimens of patients. The factors associated with tumor positive re-excision specimen were, age ≤50 years(p=0.044), lymphovascular invasion (p=0.029), multifocality(p<0.001), tumor size >2cm(p=0.008), presence of DCIS(p=0.018), focal margin positivity(p<0.001), DCIS at resection margin(p=0.008) and node positivity (p<0.001). Conclusions: Most of our patients with early breast cancer had unnecessary re-excisions or mastectomy to obtain clear surgical margins. In subset group of patients, re-excision or mastectomy may not be required. No significant financial relationships to disclose.

scholarly journals Extensive intraductal component positive carcinoma of breast: two year study with special reference to ER/PR/HER2NEU/Ki67 in a tertiary care centre of Barak Valley

2020 ◽  
Vol 8 (6) ◽  
pp. 2110
Author(s):  
Madhusmita Choudhury ◽  
Monoj K. Deka ◽  
Anuradha Talukdar ◽  
Nitu M. Khakhlari ◽  
Jyoti Chaubey
Keyword(s):  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Tertiary Care ◽  
Surgical Margin ◽  
Margin Status ◽  
Extensive Intraductal Component ◽  
Tertiary Care Centre ◽  
Ki 67 ◽  
Cross Sectional ◽  
Intraductal Component

Background: Extensive intraductal component positive carcinoma (EICPC) of breast is defined by Schnitt et al as-A. 25% or more of Ductal carcinoma in situ (DCIS) is present along the invasive lesion and DCIS is also present outside the area of invasive carcinoma. B. EICPC also include carcinomas in which DCIS is associated with a “small” (approximately 10 mm or less) invasive carcinoma or carcinomas. In Extensive Intraductal Carcinoma (EIDC) most of the cases were associated with recurrence when surgical margin status is not evaluated or focally involved. Our objective was to study the prevalence of EIDC and expression of estrogen receptor (ER)/progesterone receptor (PR)/human epidermal growth factor (HER2NEU)/Ki67(antigen identified by monoclonal antibody KI67) in those cases.Methods: It was a retrospective cross sectional study conducted over a period of 2017 to August 2019.All the histologically confirmed cases of EIDC was retrieved from the institute.Results: Out of 65 cases of invasive carcinoma 17 (26.1%) cases were positive for EICPC. Age of patients ranged from 27 to 73years with mean age of 43 years and 5 patients (29.4%) were postmenopausal. Most of the cases  i.e. 6(35.2%) had a ER+/PR+/HER2NEU- status with most of the cases having high 6(47%)Ki-67 index. According to the BLOOM RICHARDSON GRADING 14 cases were grade II (82.3%) and 3 cases were grade I (17.7%) and in pT and pN staging majority were stage pT1 - 7 (41.1%). Most of the cases were mastectomy cases 11 (64.4%) with a base free status except in one lumpectomy case where margin was involved.Conclusions: In this study majority of the cases were ER+//PR+/HER2NEU- with most of the cases having high Ki67 index. Evaluation of EIDC, along with the negative margin status is important to prevent recurrence.

Rate of Re-excision after Breast-conserving Surgery for Invasive Lobular Carcinoma

2013 ◽  
Vol 79 (10) ◽  
pp. 1119-1122 ◽  
Author(s):  
Morcos L. Wanis ◽  
Jennifer A. Wong ◽  
Samuel Rodriguez ◽  
Jasmine M. Wong ◽  
Brice Jabo ◽  
...  
Keyword(s):  
Invasive Lobular Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Surgical Margin ◽  
Positive Margin ◽  
Breast Conserving Surgery ◽  
Positive Surgical Margin ◽  
Close Margin ◽  
Cross Sectional ◽  
Positive Margins

Invasive lobular carcinoma (ILC) accounts for approximately 5 to 20 per cent of all breast cancers and is often multicentric. Despite pre- and intraoperative assessments to achieve negative margins, ILC is reported to be associated with higher rates of positive margin. This cross-sectional study examined patients with breast cancer treated at our institution from 2000 to 2010. The objective was to investigate the rate of re-excision resulting from positive or close margin (1 mm or less) in patients who underwent breast-conserving surgery (BCS) for ILC compared with invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS). Of the 836 patients treated, 416 patients underwent BCS. The rate of re-excision after BCS for ILC was 35.1 versus 17.7 per cent for IDC and 20.0 per cent for DCIS ( P = 0.04). Re-excisions were more often performed for positive margin in patients with ILC (11 of 37 [29.7%]) versus IDC (36 of 334 [10.8%]) and DCIS (five of 45 [11.1%];( P = 0.004). In this single-institution review, BCS for ILC had significantly higher rates of re-excision as a result of positive margins when compared with IDC and DCIS. Tumor size greater than 2 cm and lymph node involvement were identified as factors associated with positive surgical margin in ILC. The higher possibility of positive margins and the need for additional procedures should be discussed with patients undergoing BCS for ILC.

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