Influence of tumour bed assessment on local recurrence following breast-conserving surgery for breast cancer.
OBJECTIVE
To assess the impact of adopting a policy of tumour bed assessment with selective re-excision in patients undergoing breast-conserving surgery for breast cancer.


METHODS
Tumour bed assessment was introduced in our institution in 1988. Patients treated prior to 1988 (125 patients) were compared with patients treated post-1988 (239 patients) for clinico-pathological factors, surgical and adjuvant therapy. Outcome measures were examined at a fixed 5-year follow-up period for each patient.


RESULTS
There were a greater number of small, node-negative, oestrogen receptor tumours post-1988, probably due to the influence of the National Breast Screening Programme. There was also a difference in the prescription of adjuvant systemic therapy between the two cohorts. The incidence of tumour bed positivity was 30.5%. The re-excision rate was 16.4%. There was a significant fall in the incidence of local recurrence from pre-1988 (15.7%) to post-1988 (2.5%).


CONCLUSIONS
By adopting a policy of tumour bed assessment with selective re-excision, a low local recurrence rate has been achieved. The improvement in systemic recurrence and breast cancer-related death rate are mainly secondary to other factors.
Malik
H Z
HZ
University Department of Surgery, Western Infirmary, Glasgow, UK.
Purushotham
A D
AD
Mallon
E A
EA
George
W D
WD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016019:Survival Analysis