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01.11.2010 | Breast Oncology | Ausgabe 11/2010

Annals of Surgical Oncology 11/2010

The Effect of Simultaneous Peripheral Excision in Breast Conservation upon Margin Status

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 11/2010
Autoren:
MD Roshani R. Patel, MS Tianyu Li, PhD Eric A. Ross, MSN, CRNP, AOCNP Linda Sesa, MD, PhD Elin R. Sigurdson, MD Richard J. Bleicher
Wichtige Hinweise
Presented, in part, at the Annual Meeting of the American Society of Breast Surgeons, San Diego, CA, April, 24, 2009.

Abstract

Background

Negative margins in breast conservation therapy (BCT) decrease local recurrence risk. Excision may be performed via two techniques: either as a single lumpectomy specimen or as a central segment with simultaneously resected peripheral segments (PSs). There is little data directly comparing these methods for their effect on margin status.

Materials and Methods

A retrospective review of all patients undergoing BCT for invasive breast cancer was conducted to evaluate and compare the two techniques. Presentation, pathologic characteristics, surgical technique, specimen volume, and final margin status were recorded.

Results

Among 259 cancers in 257 women, 33 had positive margins. A single segment was removed in 69 patients, while 190 patients had 1–6 PSs simultaneously removed. By univariate analysis, smaller tumor size (P = .017) and greater numbers of segments removed (P = .01) lowered the risk of positive margins. In a multivariate model, smaller tumor size (P = .0024), lack of EIC (P = .049), and greater numbers of segments removed (P = .0061) lowered the risk of margin positivity. Despite this last predictor, the total resected specimen volume did not increase with the number of PSs removed (P = .4). There was no residual tumor in 49.2% of PSs despite a compromised primary segment margin.

Conclusions

Smaller tumor size, lack of EIC, and greater numbers of simultaneous PSs excised decrease the likelihood of positive margins, despite a lack of correlation between segment numbers and excised volume. These findings suggest that excision of simultaneous PSs may assist in achieving negative margins, in part, because of avoidance of pathologic artifact.

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