The impact of margin status in breast-conserving therapy for lobular carcinoma is age related.
OBJECTIVE
The aim is to look at the impact of margin status and outcome of invasive lobular carcinoma (ILC) treated with breast-conserving therapy (BCT).


METHODS
This manuscript describes an analysis on 330 BCT in 318 patients with ILC.


RESULTS
The 12-year local relapse free survival (LRFS) is 89%. In multivariate analysis, positive margin status, age>50 years, contra lateral breast cancer, and adjuvant systemic therapy were significant predictors of local relapse free survival. In a separate analysis limited to a positive margin for invasive carcinoma or carcinoma in situ, only a positive margin for invasive carcinoma was a significant predictor of local relapse free survival. This was limited to women<or=50 years. The 12-year disease-specific survival (DSS) was 85%. In multivariate Cox regression analysis grade 3 compared to grade 2 (HR 7.2), and a tumour size of pT2 (HR 2.5) were significant independent predictors of disease-specific survival (DFS). These factors were also relevant for distant metastasis-free survival (DMFS) and disease-free survival (DFS).


CONCLUSIONS
Positive margins for invasive carcinoma seem to be a strong predictor for local recurrence in particular for women<or=50-years. Our study showed grade 3 and tumour size to be strong predictors of DMFS, DFS, and DSS. Margin status was not.
Jobsen
J J
JJ
Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands. j.jobsen@mst.nl
Riemersma
S
S
van der Palen
J
J
Ong
F
F
Jonkman
A
A
Struikmans
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D015996:Survival Rate