Margin assessment after neoadjuvant chemotherapy in invasive lobular cancer.
BACKGROUND
Optimal surgical management of patients with invasive lobular carcinoma (ILC) who undergo neoadjuvant chemotherapy (NAC) is unknown. We evaluated optimal margin distance and local recurrence (LR) rates for these patients.


METHODS
Ninety-three (30%) of 311 patients with ILC received NAC. We examined margin status, residual disease after re-excision, and clinical outcomes.


RESULTS
Margin positivity rates after the final operative procedure were similar between the NAC and surgery-first group (P > .05). The proportion of patients, stratified by margin status, who were taken back for re-excision was not different between the 2 groups, and, similarly, there were no differences in frequency of residual disease (all P > .05). At a median follow-up of 3.1 years, 1 patient in the NAC group and 2 in the surgery-first group developed LR (P = 1.0).


CONCLUSIONS
Patients with ILC who have undergone NAC and have margins >1 mm have a low probability of residual disease and LR.
Department of Surgical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.
Jamie
J
Wagner
Judy C
JC
Boughey
Betsy
B
Garrett
Gildy
G
Babiera
Henry
H
Kuerer
Funda
F
Meric-Bernstam
Eva
E
Singletary
Kelly K
KK
Hunt
Lavinia P
LP
Middleton
Isabelle
I
Bedrosian
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome