Factors Associated with Re-excision after Breast-Conserving Surgery for Early-Stage Breast Cancer.
10.4048/jbc.2012.15.4.412
- Author:
Woohyun JUNG
1
;
Eunyoung KANG
;
Sun Mi KIM
;
Dongwon KIM
;
Yoonsun HWANG
;
Young SUN
;
Cha Kyong YOM
;
Sung Won KIM
Author Information
1. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. brcakorea@gmail.com
- Publication Type:Original Article
- Keywords:
Breast neoplasms;
Safety of margin;
Segmental mastectomy
- MeSH:
Breast;
Breast Neoplasms;
Carcinoma, Intraductal, Noninfiltrating;
Frozen Sections;
Humans;
Magnetic Resonance Imaging;
Mastectomy, Segmental;
Medical Records;
Multivariate Analysis;
Retrospective Studies
- From:Journal of Breast Cancer
2012;15(4):412-419
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Re-excisions after breast-conserving surgery (BCS) for breast cancer cause delays in the adjuvant treatment, increased morbidity, and leads to poor aesthetic results. Thus, efforts to reduce the re-excision rate are essential. This study aimed to conclusively determine the re-excision rate and the factors associated with re-excision after BCS. METHODS: We retrospectively reviewed the medical records and pathological reports of 711 cases that underwent BCS for early-stage breast cancer. Univariate and multivariate analyses were performed. RESULTS: Of the 711 cases of BCS, 71 (10.0%) required re-excision. Patients in the re-excision group were younger than those in the no re-excision group. Non-palpable lesions, the presence of non-mass-like enhancement at magnetic resonance imaging, multifocality, the presence of a ductal carcinoma in situ (DCIS) component, and an infiltrative tumor border were also significantly associated with re-excision. Multivariate analysis indicated that younger age, non-palpable lesions, multifocal lesions, and the presence of a DCIS component were factors which were independently associated with re-excision. Tumors located in the lower inner quadrant had a relatively high involved resection margin rate as well as a narrow resection margin width, especially at the superior and medial margins. Lateral margins showed a tendency toward a wider resection margin width. CONCLUSION: At our institution, the rate of re-excision was low despite the lack of an intraoperative frozen section. Patients with non-palpable or multifocal tumors, a DCIS component, or those who were younger than 50 years were more likely to require re-excision after BCS. These factors should be considered when planning surgical management of early-stage breast cancer. Positive resection margin rates and margin widths differed on a directional basis based on tumor location, and these differences were considerable.
