title: Biopsy findings after breast conservation therapy for early-stage invasive breast cancer.
abstract: OBJECTIVE
  To determine the patterns and factors predictive of positive ipsilateral breast biopsy after conservation therapy for early-stage breast cancer.
  
  
  METHODS
  We performed a retrospective review of Stage I-II breast cancer patients initially treated with lumpectomy and radiotherapy between 1977 and 1996, who later underwent post-treatment ipsilateral breast biopsies.
  
  
  RESULTS
  A total of 223 biopsies were performed in 193 treated breasts: 171 single and 22 multiple biopsies. Of the 223 biopsies, 56% were positive and 44% were negative for recurrence. The positive biopsy rate (PBR) was 59% for the first and 32% for subsequent biopsies. The median time to the first post-treatment biopsy was 49 months. Of the patients with negative initial biopsy findings, 11% later developed local recurrence. The PBR was 40% among patients with physical examination findings only, 65% with mammographic abnormalities only, and 79% with both findings (p = 0.001). Analysis of the procedure type revealed a PBR of 86% for core and 58% for excisional biopsies compared with 28% for aspiration cytology alone (p = 0.025). The PBR varied inversely with age at the original diagnosis: 49% if >or=51 years, 57% if 36-50 years, and 83% if <or=35 years (p = 0.05). The PBR correlated directly with the interval after radiotherapy: 49% if <or=60 months, 59% if 60.1-120 months, 77% if 120.1-180 months, and 100% if >180 months after completing postlumpectomy radiotherapy (p = 0.01). The PBR was not linked with recurrence location, initial pathologic T or N stage, estrogen receptor/progesterone receptor status, or final pathologic margins (all p >or= 0.15).
  
  
  CONCLUSIONS
  After definitive radiotherapy for early-stage breast cancer, a greater PBR was associated with the presence of both mammographic and clinical abnormalities, excisional or core biopsies, younger age at the initial diagnosis, and longer intervals after radiotherapy completion.
authors.affiliation: Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA. vapiwala@xrt.upenn.edu
authors.forename: Neha
authors.initials: N
authors.lastname: Vapiwala
authors.forename: Jill
authors.initials: J
authors.lastname: Starzyk
authors.forename: Eleanor E
authors.initials: EE
authors.lastname: Harris
authors.forename: Julia C
authors.initials: JC
authors.lastname: Tchou
authors.forename: Marcia C
authors.initials: MC
authors.lastname: Boraas
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Czerniecki
authors.forename: Ernest F
authors.initials: EF
authors.lastname: Rosato
authors.forename: Susan G
authors.initials: SG
authors.lastname: Orel
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Solin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy / Q000706:statistics & numerical data; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D012189:Retrospective Studies