title: Outcome analysis of patients with early infiltrating breast carcinoma treated by surgery with intraoperative evaluation of surgical margins.
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of intraoperative evaluation of surgical margins (IESM) on the local recurrence rate, the occurrence of distant metastases and survival in invasive breast carcinoma (T1-2).
  
  
  METHODS
  Two groups of patients were compared: a control group of 149 patients treated by classical quadrantectomy without IESM, and an IESM study group of 102 patients submitted to surgical treatment guided by this procedure. In the IESM group 64 quandrantectomies, 33 enlarged quadrantectomies and five mastectomies were performed.
  
  
  RESULTS
  In the control group 17 local recurrences (11.4%), 49 distant metastases (39.2%) and 43 deaths (31.5%) occurred; in the IESM group there were no local recurrences, nine distant metastases occurred (8.8%) and three patients died (2%). Adjuvant treatment was the same in both groups. The survival curves were estimated by the Kaplan-Meier method and compared with the log-rank test. The curves were censored at 99 months of follow-up for adequate comparison because the follow-up period was different in the two groups. Significant differences in local recurrence-free survival and distant metastasis-free survival curves (P = 0.001) in favor of the study group were observed. The overall survival curve of the IESM group was also superior, but statistical analysis revealed only a strong tendency without significance (P = 0.06).
  
  
  CONCLUSIONS
  Treatment of early infiltrating breast carcinoma guided by IESM results in a better prognosis.
authors.affiliation: Gynecologic Clinic of the University of São Paulo Medical School, São Paulo, Brazil. clinab@terra.com.br
authors.forename: Alfredo C S D
authors.initials: AC
authors.lastname: Barros
authors.forename: Mariane
authors.initials: M
authors.lastname: Pinotti
authors.forename: Luis Carlos
authors.initials: LC
authors.lastname: Teixeira
authors.forename: Marcos Desidério
authors.initials: MD
authors.lastname: Ricci
authors.forename: José Aristodemo
authors.initials: JA
authors.lastname: Pinotti
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome