title: Residual disease after excision of non-palpable breast tumours: analysis of tumour characteristics.
abstract: BACKGROUND
  A tumour-positive resection margin is a well-known prognostic factor for local recurrence. The aim of this study was to evaluate tumour characteristics that might be predictive for the presence of residual disease after excisional surgery.
  
  
  METHODS
  Data of 295 patients, subjected to a wire-guided excisional breast biopsy were studied. Type and size of the primary tumour, the presence of DCIS and an extensive in situ component (EIC), multifocality of the tumour and nodal status were recorded.
  
  
  RESULTS
  Residual disease was found in 51% of the patients undergoing a re-operation. 80% of the patients with positive margins were treated by mastectomy. Nodal status and the presence of an extensive in situ component were the only two variables that were statistically significant.
  
  
  CONCLUSIONS
  In case of tumour positive margins axillary involvement and an extensive in situ component in the primary tumour were predictive for residual disease. No subgroups could be defined in whom additional surgery could be omitted. More 'aggressive' surgical therapy is justified in patients belonging to these risk groups.
authors.affiliation: Department of Surgery, Rijnstate Hospital Arnhem, PO Box 9555, 6800 TA Arnhem, The Netherlands.
authors.forename: M L E A
authors.initials: ML
authors.lastname: Landheer
authors.forename: J H G
authors.initials: JH
authors.lastname: Klinkenbijl
authors.forename: P C M
authors.initials: PC
authors.lastname: Pasker-de Jong
authors.forename: Th
authors.initials: T
authors.lastname: Wobbes
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D015412:Mastectomy, Segmental / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis