title: Factors associated with re-excision in patients with early-stage breast cancer treated with breast conservation therapy.
abstract: One of the risks of breast conservation surgery is local recurrence, which predominantly occurs as a result of inadequate surgical margins. The purpose of this study was to identify factors associated with close or positive surgical margins leading to reexcision (RE). The charts of 532 consecutive breast cancer patients treated at our center between September 2001 and June 2007 were reviewed to evaluate patients who opted for breast conservation surgery and needed reexcision. A total of 351 patients were treated with breast conservation, of which 118 (34%) had positive or close surgical margins and went on to RE. On univariate analysis, factors that significantly correlated with RE (P < 0.05) were preoperative diagnosis, final pathology, size of tumor, and presentation with nipple discharge. RE was necessary in 53 per cent of patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS), 57 per cent of patients diagnosed by surgical excision, 86 per cent of patients presenting with nipple discharge, and 87 per cent of patients with DCIS or invasive carcinoma with extensive intraductal component in the final pathology. Additionally, 53 per cent of patients with T3 tumors required RE. Age, race, and grade of tumor had no effect on RE rates. Most (75%) patients were able to ultimately have breast conservation.
authors.affiliation: Department of Surgery, Breast Care Center, The George Washington University Medical Center, Washington, D.C., USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Sanchez
authors.forename: Rachel F
authors.initials: RF
authors.lastname: Brem
authors.forename: Anita P
authors.initials: AP
authors.lastname: McSwain
authors.forename: Jocelyn A
authors.initials: JA
authors.lastname: Rapelyea
authors.forename: Jessica
authors.initials: J
authors.lastname: Torrente
authors.forename: Christine B
authors.initials: CB
authors.lastname: Teal
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies