Positive margins following surgical resection of breast carcinoma: analysis of pathologic correlates.
OBJECTIVE
Histologic margin positivity represents a significant source of adverse clinical outcome affecting breast conservation therapy for in situ or invasive malignancy. Elucidation of factors associated with positive margin status might clarify and improve local therapy strategies. In order to define our experience with margin positivity and to identify relevant pathologic criteria, we retrospectively analyzed the cases of 143 patients who underwent resections for carcinoma with intent of breast conservation between 1995 and 1999.


METHODS
Histologic features and indices of biologic aggressiveness were compared among tumors resected with positive versus negative margins in order to determine whether such markers could be used to anticipate outcome.


RESULTS
Twenty-eight pathologic specimens were identified to possess histologically positive margins. Twenty-six patients underwent additional operative procedures. Of the 26 re-excision specimens, 17 (65%) contained residual malignancy. Statistical analysis demonstrated that margin positivity correlated with in situ histology and with Her 2/neu positivity.


CONCLUSIONS
These data suggest certain pathologic factors that may portend difficulty in achieving negative resection margins in patients in whom breast conservation therapy is considered.
Miller
Alexander R
AR
Division of Surgical Oncology, Cancer Therapy and Research Center, San Antonio, Texas 78229-3900, USA. amiller@idd.org
Brandao
Guillermo
G
Prihoda
Thomas J
TJ
Hill
Cheryl
C
Cruz
Anatolio B
AB
Yeh
I-Tien
IT
D000368:Aged; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000737:chemistry / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D018365:Neoplasm, Residual; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D012189:Retrospective Studies; D016896:Treatment Outcome
D018719:Erb-b2 Receptor Tyrosine Kinases