Local recurrence in lumpectomy patients after imprint cytology margin evaluation.
BACKGROUND
This is a follow-up study to our previously reported data on local recurrence rates in patients whose lumpectomy margins were evaluated by intraoperative imprint cytology (IIC(M)). The purpose of this study was to compare local recurrence rates for patients whose lumpectomy margins were evaluated with IIC(M) with local recurrence rates of those not evaluated by IIC(M).


METHODS
A total of 1713 patients underwent lumpectomy treatment for breast cancer from 1988 to 2001 were prospectively entered into a computerized database and subsequently included in this study. Of the patients, 520 (group 1) had their surgery performed at an outside institution where conventional margin analysis was performed. Another 1193 (group 2) had their surgery performed at our institution where margins were evaluated by IIC(M). For each histologic type and for the overall sample, probabilities of recurrence with time were estimated using the method of Kaplan and Meier.


RESULTS
IIC(M) overcomes sampling error inherent in the frozen section analysis and results in a diminished incidence of overall 5-year local recurrence from 8.8% to 2.8% (P <0.0001). The recurrence rates for each respective histologic subtype are reported for both absolute recurrences and probability of recurrence with time.


CONCLUSIONS
IIC(M) provides an accurate evaluation of lumpectomy margins for patients undergoing breast-conservation treatment. IIC(M) was associated with an overall lower local recurrence rate. This series defined the utility of intraoperative imprint cytology for evaluation of margins in patients undergoing breast-conservation treatment.
Comprehensive Breast Cancer Program, Department of Surgery, H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, 12902 Magnolia Dr., Tampa, FL 33612, USA.
Elizabeth
E
Weinberg
Charles
C
Cox
Elisabeth
E
Dupont
Laura
L
White
Mark
M
Ebert
Harvey
H
Greenberg
Nils
N
Diaz
Vesna
V
Vercel
Barbara
B
Centeno
Alan
A
Cantor
Santo
S
Nicosia
D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011446:Prospective Studies