Immediate effects of intraoperative evaluation of surgical margins over the treatment of early infiltrating breast carcinoma.
OBJECTIVE
Local recurrences in patients submitted to conservative breast treatment for early infiltrating breast carcinomas occur in 5-10% of the cases and are caused mainly by inadequate local resection and remaining residual malignant tissue. The present study was carried out to analyze the effect of intraoperative evaluation of surgical margins and its influence on the immediate surgical management of patients with early breast carcinomas (T1-T2) scheduled to undergo quadrantectomy.


METHODS
A total of 102 cases were studied. After a classical quadrantectomy, intraoperative evaluation of surgical margins was done by means of macroscopic, cytological and histopathologic analysis. The margins of the resected tissue were examined to assure they were clear or to orient a wider resection.


RESULTS
In 64 cases (62.7%), the extent of the quadrant resection was considered adequate and the margins were clear. In 38 cases (37.3%), surgical margins were considered inadequate. An enlarged quadrantectomy was immediately performed in 33 patients (32.4%) and mastectomies in 5 (4.9%).


CONCLUSIONS
Intraoperative evaluation of surgical margins frequently modifies the surgical management of patients who were initially prepared to be submitted to a quadrantectomy, indicating the need for further resection in the form of an enlarged quadrantectomy or mastectomy.
Gynecologic Clinic of the University of São Paulo Medical School, São Paulo, Brazil. acbarros.ops@terra.com.br
Alfredo
A
Barros
Marianne
M
Pinotti
Marcos Desiderio
MD
Ricci
Antonio Carlos
AC
Nisida
José Aristodemo
JA
Pinotti
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000473:pathology / Q000601:surgery; D018276:Carcinoma, Medullary / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D016896:Treatment Outcome