Margin status and local recurrence after breast-conserving surgery.
OBJECTIVE
To examine the effect of microscopic tumor at the margins on local recurrence after breast-conserving surgery for invasive carcinoma.


METHODS
Retrospective review of patients treated with surgical resection followed by radiation therapy.


METHODS
A university-based radiation department and a community-based cancer referral center.


METHODS
A consecutive series of 272 women treated between 1982 and 1990.


METHODS
Local recurrence according to the histopathologic status of excised margins and the total dose of radiation.


RESULTS
During a mean follow-up period of 48 months, the overall rate of local recurrence was 6.3%. Local recurrence was more frequent (P = .0001) in patients with histologically positive margins (18.2%) than in those with unknown margins (7.1%) or negative margins (3.7%). In the 44 patients with positive margins, the local recurrence rate was 8.3% after radiation doses of 66 Gy or more compared with 21.9% following lower doses.


CONCLUSIONS
Microscopic involvement of resection margins increases the risk of local recurrence following breast-conserving surgery for invasive carcinoma. Therefore, every effort should be made to achieve negative margins intraoperatively.
Spivack
B
B
Joyce Eisenberg Keefer Breast Center, Saint John's Hospital and Health Center, Santa Monica, Calif.
Khanna
M M
MM
Tafra
L
L
Juillard
G
G
Giuliano
A E
AE
D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000473:pathology / Q000601:surgery; D018276:Carcinoma, Medullary / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies