title: Margin status and local recurrence after breast-conserving surgery.
abstract: 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.
authors.affiliation: Joyce Eisenberg Keefer Breast Center, Saint John's Hospital and Health Center, Santa Monica, Calif.
authors.forename: B
authors.initials: B
authors.lastname: Spivack
authors.forename: M M
authors.initials: MM
authors.lastname: Khanna
authors.forename: L
authors.initials: L
authors.lastname: Tafra
authors.forename: G
authors.initials: G
authors.lastname: Juillard
authors.forename: A E
authors.initials: AE
authors.lastname: Giuliano
mesh_terms: 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